Cesarean section and diabetes during pregnancy: An NSW population study using the Robson classification

Zeki, R; Oats, JJN; Wang, AY; Li, Z; Homer, CSE; Sullivan, EA

Cesarean section and diabetes during pregnancy: An NSW population study using the Robson classification

Zeki, R

Oats, JJN Wang, AY

Li, Z

Homer, CSE

Sullivan, EA

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Publication Type:: Journal Article
Citation:: Journal of Obstetrics and Gynaecology Research, 2018, 44 (5), pp. 890 - 898
Issue Date:: 2018-05-01

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Field	Value	Language
dc.contributor.author	Zeki, R https://orcid.org/0000-0002-6319-2500	en_US
dc.contributor.author	Oats, JJN	en_US
dc.contributor.author	Wang, AY https://orcid.org/0000-0002-3656-4284	en_US
dc.contributor.author	Li, Z https://orcid.org/0000-0002-7622-150X	en_US
dc.contributor.author	Homer, CSE https://orcid.org/0000-0002-7454-3011	en_US
dc.contributor.author	Sullivan, EA https://orcid.org/0000-0002-8718-2753	en_US
dc.date.available	2020-05-25T19:03:20Z
dc.date.issued	2018-05-01	en_US
dc.identifier.citation	Journal of Obstetrics and Gynaecology Research, 2018, 44 (5), pp. 890 - 898	en_US
dc.identifier.issn	1341-8076	en_US
dc.identifier.uri	http://hdl.handle.net/10453/129022
dc.description.abstract	© 2018 Japan Society of Obstetrics and Gynecology Aim: The aim of this study was to identify the main contributors to cesarean section (CS) among women with and without diabetes during pregnancy using the Robson classification and to compare CS rates within Robson groups. Methods: A population-based cohort study was conducted of all women who gave birth in New South Wales, Australia, between 2002 and 2012. Women with pregestational diabetes (types 1 and 2) and gestational diabetes mellitus (GDM) were grouped using the Robson classification. Adjusted odd ratios (AOR) and 95% confidence intervals (CI) were calculated using multivariable logistic regression. Results: The total CS rate was 53.6% for women with pregestational diabetes, 36.8% for women with GDM and 28.5% for women without diabetes. Previous CS contributed the most to the total number of CS in all populations. For preterm birth, the contribution to the total was 20.5% for women with pregestational diabetes and 5.7% for women without diabetes. Compared to women without diabetes, for nulliparous with pregestational diabetes, the odds of CS was 1.4 (95% CI, 1.1–1.8) for spontaneous labor and 2.0 (95% CI, 1.7–2.3) for induction of labor. Conclusion: A history of CS was the main contributor to the total CS. Reducing primary CS is the first step to lowering the high rate of CS among women with diabetes. Nulliparous women were more likely to have CS if they had pregestational diabetes. This increase was also evident in all multiparous women giving birth. The high rate of preterm births and CS reflects the clinical issues for women with diabetes during pregnancy.	en_US
dc.relation.ispartof	Journal of Obstetrics and Gynaecology Research	en_US
dc.relation.isbasedon	10.1111/jog.13605	en_US
dc.subject.classification	Obstetrics & Reproductive Medicine	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Diabetes, Gestational	en_US
dc.subject.mesh	Pregnancy in Diabetics	en_US
dc.subject.mesh	Cesarean Section	en_US
dc.subject.mesh	Cohort Studies	en_US
dc.subject.mesh	Pregnancy	en_US
dc.subject.mesh	Adult	en_US
dc.subject.mesh	New South Wales	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Young Adult	en_US
dc.title	Cesarean section and diabetes during pregnancy: An NSW population study using the Robson classification	en_US
dc.type	Journal Article
utslib.citation.volume	5	en_US
utslib.citation.volume	44	en_US
utslib.for	1114 Paediatrics and Reproductive Medicine	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Public Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Science
pubs.organisational-group	/University of Technology Sydney/Faculty of Science/School of Mathematical and Physical Sciences
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
pubs.organisational-group	/University of Technology Sydney/Strength - WHO CC
utslib.copyright.status	open_access
pubs.issue	5	en_US
pubs.publication-status	Published	en_US
pubs.volume	44	en_US

Abstract:

© 2018 Japan Society of Obstetrics and Gynecology Aim: The aim of this study was to identify the main contributors to cesarean section (CS) among women with and without diabetes during pregnancy using the Robson classification and to compare CS rates within Robson groups. Methods: A population-based cohort study was conducted of all women who gave birth in New South Wales, Australia, between 2002 and 2012. Women with pregestational diabetes (types 1 and 2) and gestational diabetes mellitus (GDM) were grouped using the Robson classification. Adjusted odd ratios (AOR) and 95% confidence intervals (CI) were calculated using multivariable logistic regression. Results: The total CS rate was 53.6% for women with pregestational diabetes, 36.8% for women with GDM and 28.5% for women without diabetes. Previous CS contributed the most to the total number of CS in all populations. For preterm birth, the contribution to the total was 20.5% for women with pregestational diabetes and 5.7% for women without diabetes. Compared to women without diabetes, for nulliparous with pregestational diabetes, the odds of CS was 1.4 (95% CI, 1.1–1.8) for spontaneous labor and 2.0 (95% CI, 1.7–2.3) for induction of labor. Conclusion: A history of CS was the main contributor to the total CS. Reducing primary CS is the first step to lowering the high rate of CS among women with diabetes. Nulliparous women were more likely to have CS if they had pregestational diabetes. This increase was also evident in all multiparous women giving birth. The high rate of preterm births and CS reflects the clinical issues for women with diabetes during pregnancy.

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http://hdl.handle.net/10453/129022