Associated Factors for Cesarean Section in Pregnant Women with Gestational Diabetes Mellitus.

INTRODUCTION

Women with gestational diabetes mellitus (GDM) have an increased risk of undergoing cesarean section (CS). This study aimed to identify factors associated with CS in women with GDM.

METHODS

A retrospective observational study was conducted on patients with GDM who delivered at Hainan General Hospital between January 2021 and June 2023. The patients were grouped by delivery type: CS vs. vaginal. A multivariable logistic regression model was used to identify the factors associated with CS.

RESULTS

Of the 1689 women with GDM, 731 had CS. Logistic regression revealed that CS was independently associated with maternal age (OR: 1.07, 95% CI: 1.04-1.10, p < 0.001), pre-pregnancy body mass index (BMI) (OR: 1.05, 95% CI: 1.02-1.08, p = 0.003), and education level (high school education: OR: 1.53, 95% CI: 1.08-2.17, p = 0.018; bachelor's degree or higher: OR: 1.58, 95% CI: 1.13-2.23, p = 0.008). The most significant associated perinatal factor was cephalopelvic disproportion (including breech presentation or other abnormal fetal positions) (OR: 12.31, 95% CI: 1.46-104.11, p = 0.021). The absence of a past medical history of heart disease (OR: 0.26, 95% CI: 0.07-0.859, p = 0.031) was inversely independently associated with CS.

CONCLUSION

Higher maternal age, elevated BMI, higher education, specific perinatal diagnoses, and the presence of a history of heart disease were independently associated with CS in women with GDM.