RESUMO
OBJECTIVE: Due to the high incidence of neonatal complications in diabetic pregnancies, the aim of our study was to investigate whether elective cesarean section could prevent adverse neonatal outcome. DESIGN: Population-based study. SETTING: Data were extracted from the Swedish Medical Birth Registry. POPULATION: All women (n=13 491) with diabetic pregnancies during the period 1990-2007. METHODS: Neonatal outcome in diabetic pregnancies was compared after elective cesarean section at 38 completed gestational weeks with planned vaginal delivery at 39 completed weeks of gestation or later. Odds ratios with 95% confidence intervals for Apgar scores <7 at 5 min after birth were calculated using multiple logistic regression. MAIN OUTCOME MEASURES: Apgar score <7 at 5 min after birth. RESULTS: A significantly decreased risk of Apgar score <7 at 5 min after birth in the group who underwent an elective cesarean section at 38 completed gestational weeks was found compared with those who continued pregnancy to 39 completed weeks of gestation or more, irrespective of final mode of delivery. CONCLUSIONS: Our results indicate a protective effect of planned cesarean section on the risk of low Apgar scores in diabetic pregnancies.