Associated Factors for Cesarean Section in Pregnant Women with Gestational Diabetes Mellitus

Introduction: Women with gestational diabetes mellitus (GDM) have an increased risk of undergoing cesarean section (CS). This study aimed to identify factors associated with CS in women with GDM. Methods: A retrospective observational study was conducted on patients with GDM who delivered at Hainan General Hospital between January 2021 and June 2023. The patients were grouped by delivery type: CS vs. vaginal. A multivariable logistic regression model was used to identify the factors associated with CS. Results: Of the 1689 women with GDM, 731 had CS. Logistic regression revealed that CS was independently associated with maternal age (OR: 1.07, 95% CI: 1.04– 1.10, p < 0.001), pre-pregnancy body mass index (BMI) (OR: 1.05, 95% CI: 1.02– 1.08, p = 0.003), and education level (high school education: OR: 1.53, 95% CI: 1.08– 2.17, p = 0.018; bachelor’s degree or higher: OR: 1.58, 95% CI: 1.13– 2.23, p = 0.008). The most significant associated perinatal factor was cephalopelvic disproportion (including breech presentation or other abnormal fetal positions) (OR: 12.31, 95% CI: 1.46– 104.11, p = 0.021). The absence of a past medical history of heart disease (OR: 0.26, 95% CI: 0.07– 0.859, p = 0.031) was inversely independently associated with CS. Conclusion: Higher maternal age, elevated BMI, higher education, specific perinatal diagnoses, and the presence of a history of heart disease were independently associated with CS in women with GDM.