title: Gestational diabetes mellitus: a risk factor for non-elective cesarean section.
abstract: OBJECTIVE
  To assess whether gestational diabetes mellitus (GDM) is associated with non-elective cesarean section.
  
  
  METHODS
  A retrospective cohort study was conducted at the Department of Obstetrics of a level III hospital. Between January 2004 and November 2007, women admitted in labor or with spontaneous rupture of membranes, at term, and with a singleton cephalic presenting fetus were eligible. From these, 220 women with GDM and 660 glucose-tolerant women, delivered immediately after, were selected. The association between GDM and non-elective cesarean was estimated using modified Poisson regression analysis. Relative risks were adjusted for age, pre-pregnancy body mass index, gestational weight gain, previous cesarean, gestational age at delivery and birthweight.
  
  
  RESULTS
  Non-elective cesarean section rate for women with GDM was 19.5% compared to 13.5% for non-diabetic women. The crude relative risk of cesarean section was 1.45 (95% CI 1.04-2.02) for women with GDM. After adjustment for confounders, the association between GDM and non-elective cesarean section remained positive and statistically significant (RR = 1.52; 95% CI 1.06-2.16). No significant differences in cesarean indications were found between the two groups.
  
  
  CONCLUSIONS
  GDM was disclosed as a risk factor for non-elective cesarean section. Knowledge of the condition may have influenced obstetrical practice, favoring cesarean delivery.
authors: Departments of Gynecology and Obstetrics Endocrinology Epidemiology, São João Hospital, Faculty of Medicine, University of Porto, Porto, Portugal. rosarinhogorgal@gmail.com
authors: Rosário
authors: R
authors: Gorgal
authors: Elisabete
authors: E
authors: Gonçalves
authors: Mónica
authors: M
authors: Barros
authors: Gabriela
authors: G
authors: Namora
authors: Angela
authors: A
authors: Magalhães
authors: Teresa
authors: T
authors: Rodrigues
authors: Nuno
authors: N
authors: Montenegro
mesh_terms: D000328:Adult; D001724:Birth Weight; D002585:Cesarean Section; D016640:Diabetes, Gestational / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D005320:Fetal Macrosomia / Q000175:diagnosis / Q000503:physiopathology*; D005951:Glucose Tolerance Test; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012307:Risk Factors