Effect of labor induction on cesarean section rates in diabetic pregnancies.
OBJECTIVE
To determine if induced labor increases the incidence of cesarean delivery in pregnancies complicated by diabetes.


METHODS
This retrospective cohort study of pregnancies complicated with diabetes involved data from birth certificates reported to the New Mexico Department of Health between January 1996 and December 1999.


RESULTS
There were 108,487 births, with 3,392 (3.1%) in women with diabetes. As compared to those without diabetes, this group had an almost twofold-increased risk of primary cesarean delivery (20.3% versus 11.3%; OR 2.00; 95% CI 1.83, 2.19). The risk of primary cesarean delivery in diabetic women was lower in the presence than in the absence of induced labor (17.7% versus 21.9%; OR .77; 95% CI .50, 0.89). This association continued after controlling for birth weight > or = 4,000 g, breech presentation, twins, maternal age > 35 and gestational age > 42 weeks.


CONCLUSIONS
Induction of labor was not an independent risk factor that could explain the higher cesarean delivery rate in diabetic pregnancies.
Levy
Anna L
AL
Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Health Sciences Center, University of New Mexico, Albuquerque, NM, USA. alevy@salud.unm.edu
Gonzalez
Jose L
JL
Rappaport
Valerie J
VJ
Curet
Luis B
LB
Rayburn
William F
WF
D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007751:Labor, Induced / Q000009:adverse effects*; D009516:New Mexico / Q000453:epidemiology; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors