Gestational age at birth and mode of delivery – analysis of 1280 cases of diabetic pregnancies and review of the literature

Aleksandra Rajewska, Zbigniew Celewicz, Andrzej Torbé


Introduction: The aim of the study to analyze the gestational age at delivery, delivery mode, and indications for caesarean section in 1280 women suffering from diabetes mellitus.

Materials and methods: The gestational diabetes (GD) group was divided into classes: G1 (n = 620) of women who needed diet only, and G2 (n = 524), who needed insulin administration. The pregestational diabetes (PGD) group was categorized in subgroups: of classes B, C and D – BCD (n = 103) and of classes R, F and RF (VC – vascular complications) (n = 33).

Results: In the GD-group 4.3% of deliveries occurred in <34th week of gestation, while in the PGD-group the percentage of such births was 10.29 (p = 0.0045). The lowest percentage of deliveries <34th week was observed in G2, and the highest in the VC-subgroup. The occurrence of delivery <37th week in GD was lower than in the PGD-group (p = 0.002). It was rarest in G2 and most frequent in the VC-subgroup. The percentage of caesarean section was lower in GD than in the PGD-group (47.94 vs. 74.26; p < 0.001). In the VC-subgroup it was near 100, while the lowest occurrence was noticed in the G1-subgroup. In both groups, caesarean delivery was performed more often because of foetal indications. Foetal indications prevailed in subgroups G1, G2 and BCD, while in the VC-subgroup most indications were of maternal condition.

Conclusions: Diabetes accompanying pregnancy increases the risk of preterm birth, especially in cases of pre-pregnancy diabetes complicated by vascular disease. Caesarean delivery is more often necessary in women with pre-pregnancy diabetes than in those with gestational diabetes mellitus. The most typical caesarean section among the diabetic women is that performed because of maternal indications in pre-pregnancy diabetes complicated by vascular disease.


caesarean section; diabetes mellitus; pregnancy; preterm birth

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