Which Factors Influence the Type of Delivery and Cesarean Section Rate in Women with Gestational Diabetes?

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. STUDY DESIGN: 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. CONCLUSION: 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%.