Prevalence and risk factors of cesarean section in a population of Tunisian diabetic pregnant women

ABSTRACT

To determine the rate of and indication of cesarean section among women with preexisting and gestational diabetes mellitus compared with glucose-tolerant women. From case-control study of 400 Tunisian pregnant women [200 in group diabetes and 200 in group control] seen over a 5-year period for medical management, women who had a cesarean section were identified and the reason for the section determined from a review of the medical record. A control group of women who had a section were obtained from an existing data-base of glucose-tolerant women Women in group diabetes were significantly more aged, with higher BMI and birth weight than in control group [p<0, 05]. Global cesarean rate was significantly higher in diabetes group [50, 2%] than in control group [28, 2%] [OR=2, 72 IC[1, 76-4, 20]]. Rate of elective cesarean delivery was significantly higher in diabetes group [40, 5%] than in control group [8, 5%] [OR=4, 87 [2, 69-8, 90]]. However, vaginal delivery success rate when trial of labour was tried was similar in study groups [76%and 78%]. Most frequent indications for cesarean delivery in diabetes group were foetal macrosomia and scared uterus. Multivariate analysis showed that maternal obesity, unbalanced diabetes, unplanned pregnancy, and foetal macrosomia were significantly correlated to risk of cesarean delivery in diabetic women. Cesarean rate in our population of diabetic. pregnant women is higher than in group control. Maternal-obesity, unbalanced diabetes, unplanned pregnanc1, and foetal macrosomia were significantly correlated to risk of cesarean delivery in diabetic women