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Effect of labor induction on cesarean section rates in diabetic pregnancies
Anna L Levy1, Jose L Gonzalez, Valerie J Rappaport
1Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Health Sciences Center, University of New Mexico, Albuquerque, NM, USA. alevy@salud.unm.edu
Objective:
To determine if induced labor increases the incidence of cesarean delivery in pregnancies complicated by diabetes.
Study Design:
This retrospective cohort study of pregnancies complicated with diabetes involved data from birth certificates reported to the New Mexico Department of Health between January 1996 and December 1999.
Results:
There were 108,487 births, with 3,392 (3.1%) in women with diabetes. As compared to those without diabetes, this group had an almost twofold-increased risk of primary cesarean delivery (20.3% versus 11.3%; OR 2.00; 95% CI 1.83, 2.19). The risk of primary cesarean delivery in diabetic women was lower in the presence than in the absence of induced labor (17.7% versus 21.9%; OR .77; 95% CI .50, 0.89). This association continued after controlling for birth weight > or = 4,000 g, breech presentation, twins, maternal age > 35 and gestational age > 42 weeks.
Conclusion:
Induction of labor was not an independent risk factor that could explain the higher cesarean delivery rate in diabetic pregnancies.