Gestational diabetes mellitus: A risk factor for non-elective cesarean section
Gestational diabetes mellitus: A risk factor for non-elective cesarean section
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DOI：
10.1111/j.1447-0756.2011.01659.x
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发表时间：
2012-01-01
影响因子：
1.6
通讯作者：
Montenegro, Nuno
中科院分区：
文献类型：
--
作者：
Gorgal, Rosario;Goncalves, Elisabete;Montenegro, Nuno
目的：评估妊娠期糖尿病（GDM）是否与非选择性剖宫产相关。材料与方法：在某三级医院产科进行回顾性队列研究。 2004 年 1 月至 2007 年 11 月期间，入院分娩或足月自发性胎膜破裂且单胎头位胎儿的妇女符合资格。从这些人中，选择了 220 名患有 GDM 的女性和 660 名在分娩后立即分娩的耐葡萄糖女性。 GDM 与非选择性剖宫产之间的关联是使用改良泊松回归分析来估计的。相对风险根据年龄、孕前体重指数、妊娠体重增加、既往剖宫产史、分娩孕周和出生体重进行调整。结果：GDM 女性的非选择性剖宫产率为 19.5%，而非糖尿病女性为 13.5%。 GDM 女性剖宫产的粗略相对风险为 1.45 (95% CI 1.04-2.02)。调整混杂因素后，GDM 与非选择性剖宫产之间的关联仍然呈正相关且具有统计学显着性（RR = 1.52；95% CI 1.06-2.16）。两组之间剖宫产指征没有显着差异。结论：GDM被披露为非选择性剖宫产的危险因素。对这种情况的了解可能会影响产科实践，有利于剖腹产。
Aim: To assess whether gestational diabetes mellitus (GDM) is associated with non-elective cesarean section.Material and Methods: 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.Results: Non-elective cesarean section rate for women with GDM was 19.5% compared to 13.5% for nondiabetic 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.Conclusion: GDM was disclosed as a risk factor for non-elective cesarean section. Knowledge of the condition may have influenced obstetrical practice, favoring cesarean delivery.