Gorgal Rosário, Gonçalves Elisabete, Barros Mónica, Namora Gabriela, Magalhães Angela, Rodrigues Teresa, Montenegro Nuno
Departments of Gynecology and Obstetrics Endocrinology Epidemiology, São João Hospital, Faculty of Medicine, University of Porto, Porto, Portugal.
J Obstet Gynaecol Res. 2012 Jan;38(1):154-9. doi: 10.1111/j.1447-0756.2011.01659.x. Epub 2011 Oct 14.
To assess whether gestational diabetes mellitus (GDM) is associated with non-elective cesarean section.
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.
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.
GDM was disclosed as a risk factor for non-elective cesarean section. Knowledge of the condition may have influenced obstetrical practice, favoring cesarean delivery.
评估妊娠期糖尿病（GDM）是否与非选择性剖宫产相关。
在一家三级医院的妇产科进行了一项回顾性队列研究。2004年1月至2007年11月期间，足月入院分娩或胎膜自然破裂、单胎头先露的妇女符合条件。从中选取了220例患有GDM的妇女和660例糖耐量正常的妇女，她们均在之后立即分娩。使用修正的泊松回归分析评估GDM与非选择性剖宫产之间的关联。对年龄、孕前体重指数、孕期体重增加、既往剖宫产史、分娩时孕周和出生体重进行了相对风险调整。
患有GDM的妇女非选择性剖宫产率为19.5%，而无糖尿病的妇女为13.5%。患有GDM的妇女剖宫产的粗相对风险为1.45（95%可信区间1.04 - 2.02）。在对混杂因素进行调整后，GDM与非选择性剖宫产之间的关联仍然为阳性且具有统计学意义（RR = 1.52；95%可信区间1.06 - 2.16）。两组之间剖宫产指征无显著差异。
GDM被发现是非选择性剖宫产的一个风险因素。对该疾病的了解可能影响了产科实践，倾向于剖宫产分娩。
