title: Which Factors Influence the Type of Delivery and Cesarean Section Rate in Women with Gestational Diabetes?
abstract: OBJECTIVE
  To discover the differences between women with gestational diabetes mellitus (GDM) who delivered vaginally and those who delivered by cesarean section, and to assess the cesarean rate in this group of women.
  
  
  METHODS
  We divided all pregnant women with GDM into 2 groups: those who had vaginal delivery and those who gave birth by cesarean section (retrospective study of 6 years).
  
  
  RESULTS
  We evaluated 460 births at term (≥ 37 weeks' gestation), for a total of 240 vaginal births and 220 cesarean births. All occurred in our institution. Of all the variables that were compared between the 2 groups, we found statistically significant differences (p < 0.05) in the following factors: previous history of macrosomia and gestational age at the time of beginning insulin treatment.
  
  
  CONCLUSIONS
  Pregnant women with GDM and previous history of macrosomia are more likely to be submitted to cesarean section. Also, the initiation of insulin treatment at an early gestational age is associated with a higher chance of a woman delivering by cesarean section. The cesarean section rate in women with GDM was 47.8%.
authors.forename: Gonçalo
authors.initials: G
authors.lastname: Inocêncio
authors.forename: António
authors.initials: A
authors.lastname: Braga
authors.forename: Tânia
authors.initials: T
authors.lastname: Lima
authors.forename: Bruna
authors.initials: B
authors.lastname: Vieira
authors.forename: Rosa
authors.initials: R
authors.lastname: Zulmira
authors.forename: Maria
authors.initials: M
authors.lastname: Carinhas
authors.forename: Joaquim
authors.initials: J
authors.lastname: Gonçalves
authors.forename: Clara
authors.initials: C
authors.lastname: Silva
mesh_terms: D000293:Adolescent; D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data*; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D016640:Diabetes, Gestational / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D005320:Fetal Macrosomia / Q000453:epidemiology; D005865:Gestational Age; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D008875:Middle Aged; D011174:Portugal / Q000453:epidemiology; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin