Incidence of and factors associated with emergency caesarean section in pregnant women with gestational diabetes mellitus: A retrospective cohort study

J Obstet Gynaecol Res. 2024 May;50(5):849-855. doi: 10.1111/jog.15921. Epub 2024 Mar 7.

Abstract

Aim: The incidence of factors associated with emergency cesarean section (ECS) in patients with gestational diabetes mellitus (GDM) have not been well investigated.

Methods: We conducted a retrospective cohort study of patients diagnosed with GDM between 2011 and 2020 at a tertiary care hospital in Japan. Clinical data, vital signs, and laboratory results of the patients were collected from electronic medical records. We constructed a multivariate logistic regression model to identify the clinical characteristics associated with ECS.

Results: We included 1189 patients diagnosed with GDM, the mean maternal age was 33 years, and 507 (42.6%) patients were aged ≥35 years. In total, 114 patients underwent ECS (9.6%). The previous assisted reproductive technology (ART) use (odds ratio [OR], 1.81; 95% confidence interval [CI], 1.12-2.93), previous artificial abortion (OR, 1.94; 95% CI, 1.13-3.33), high pre-pregnancy body mass index (BMI) (OR, 1.07; 95% CI, 1.02-1.11), and late diagnosis of GDM (OR, 1.02; 95% CI, 1.003-1.05) were independently associated with ECS.

Conclusions: One of every 10 GDM patients required ECS. Previous ART use, previous artificial abortion, high pre-pregnancy BMI, and late diagnosis of GDM were risk factors for ECS in GDM patients.

Keywords: artificial abortion; assisted reproductive technology; emergency cesarean section; gestational diabetes mellitus.

MeSH terms

  • Adult
  • Cesarean Section* / statistics & numerical data
  • Diabetes, Gestational* / epidemiology
  • Emergencies
  • Female
  • Humans
  • Incidence
  • Japan / epidemiology
  • Pregnancy
  • Retrospective Studies
  • Risk Factors