Diabetes in Pregnancy and Cesarean Delivery in the State
of Virginia
Tiwanica Ames
Advisor: Dr. Saba Masho, M.D., Dr. P.H.
Preceptor: Joan Corder-Mabe, RNC, MS, WHNP
Background: Diabetes has become a major public health concern in the U.S. It poses a grave health threat to women in the reproductive age group. In addition to major complications, diabetes may increase the risk for cesarean delivery in pregnant women.
Objective: The objective of this study is to examine trends in the prevalence of diabetic pregnancies in Virginia and to determine the likelihood of cesarean delivery among women with maternal diabetes.
Methods: Birth registry data for the period of 1989 through 2002 was obtained from the Vital Statistics Department of the Virginia Department of Health. The data consisted of all singleton resident births in the state of Virginia. Prevalence rates were computed to examine trends. Data for 2001 was analyzed to determine the likelihood of cesarean delivery in Virginia among pregnancies complicated by maternal diabetes. Univariate and bivariate analyses were conducted to examine the association. Logistic regression analysis was performed to control for potential confounders.
Results: The prevalence of maternal diabetes ranged between 2.3 percent in 1989 and 3.8 percent in 2002 and has significantly increased over time (X 2=816.96, df=13, p-value < .0001). Among singleton resident births in 2001, the prevalence of maternal diabetes was 3.6 percent, while 23.5 percent of these pregnancies resulted in cesarean section. After adjusting for medical and other risk factors, women with maternal diabetes were almost twice as likely to have a cesarean delivery than non-diabetics (POR=1.74, 95% CI =1.58, 1.92).
Conclusion: The findings of this study provide evidence of an association between diabetes during pregnancy and cesarean delivery. It is apparent that the growing epidemic of diabetes in the U.S. is being reflected in our pregnant population. Prevention and intervention measures should continue to address the problem of diabetes.
