{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T02:51:45Z","timestamp":1780368705886,"version":"3.54.1"},"reference-count":31,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,2,14]],"date-time":"2018-02-14T00:00:00Z","timestamp":1518566400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Australian Government Research Training Program Scholarship"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A population\u2010based 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>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\u20131.8) for spontaneous labor and 2.0 (95% CI, 1.7\u20132.3) for induction of labor.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jog.13605","type":"journal-article","created":{"date-parts":[[2018,2,14]],"date-time":"2018-02-14T13:23:13Z","timestamp":1518614593000},"page":"890-898","source":"Crossref","is-referenced-by-count":22,"title":["Cesarean section and diabetes during pregnancy: An NSW population study using the Robson classification"],"prefix":"10.1111","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6319-2500","authenticated-orcid":false,"given":"Reem","family":"Zeki","sequence":"first","affiliation":[{"name":"The Australian Centre for Public and Population Health Research, Faculty of Health University of Technology Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy J.N.","family":"Oats","sequence":"additional","affiliation":[{"name":"Melbourne School of Population and Global Health University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex Y.","family":"Wang","sequence":"additional","affiliation":[{"name":"The Australian Centre for Public and Population Health Research, Faculty of Health University of Technology Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhuoyang","family":"Li","sequence":"additional","affiliation":[{"name":"The Australian Centre for Public and Population Health Research, Faculty of Health University of Technology Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline S.E.","family":"Homer","sequence":"additional","affiliation":[{"name":"Centre for Midwifery, Child and Family Health, Faculty of Health University of Technology Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth A.","family":"Sullivan","sequence":"additional","affiliation":[{"name":"The Australian Centre for Public and Population Health Research, Faculty of Health University of Technology Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,2,14]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ogc.2007.03.002"},{"key":"e_1_2_7_3_1","volume-title":"Diabetes in Pregnancy: Its Impact on Australian Women and their Babies","author":"Australian Institute of Health and Welfare","year":"2010"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.2011.tb03001.x"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2014-005394"},{"key":"e_1_2_7_6_1","volume-title":"Australasian Diabetes in Pregnancy Society (ADIPS) Consensus Guidelines for the Testing and Diagnosis of Gestational Diabetes Mellitus in Australia","author":"Nankervis A","year":"2013"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0707943"},{"key":"e_1_2_7_8_1","volume-title":"Department of Reproductive Health and Research","author":"World Health Organization","year":"2015"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0965539501000122"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0020-7292(09)61590-3"},{"key":"e_1_2_7_11_1","first-page":"S500","article-title":"Examination of the caesarean section rate in type I diabetes: Use of the Robson criteria to allow meaningful analysis of data","volume":"182","author":"Caroll C","year":"2013","journal-title":"Ir J Med Sci"},{"key":"e_1_2_7_12_1","first-page":"S502","article-title":"Analysis of caesarean section rates in gestational diabetes: Use of the Robson groups to allow meaningful examination of data","volume":"182","author":"Courtney W","year":"2013","journal-title":"Ir J Med Sci"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0097769"},{"key":"e_1_2_7_14_1","unstructured":"The Centre for Health Record Linkage (CHeReL). Data dictionaries 2016. [Cited 5 Jun 2016.]. Available from URL:http:\/\/www.cherel.org.au\/data\u2010dictionaries"},{"key":"e_1_2_7_15_1","unstructured":"Australian Bureau of Statistics. Australian Demographic Statistics 2016. [Cited 20 Jun 2016.]. Available from URL:http:\/\/www.abs.gov.au\/ausstats\/abs@.nsf\/mf\/3101.0\/"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.1998.tb140192.x"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2008.02431.x"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.2005.tb07087.x"},{"key":"e_1_2_7_19_1","volume-title":"Caesarean Section in Australia: National Monitoring and Classification","author":"Sullivan EA","year":"2010"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/jog.12608"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/jog.12964"},{"key":"e_1_2_7_22_1","first-page":"206","article-title":"Examining caesarean section rates in Canada using the Robson classification system","volume":"35","author":"Kelly S","year":"2013","journal-title":"JOGC"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(15)70094-X"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181c534ca"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0029-1239487"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-014-3313-6"},{"key":"e_1_2_7_27_1","first-page":"675","article-title":"Clinical management guidelines for obstetrician\u2010gynecologists. Pregestational diabetes mellitus","volume":"105","author":"The American Congress of Obstetricians and Gynecologists (ACOG)","year":"2005","journal-title":"Obstet Gynecol"},{"key":"e_1_2_7_28_1","volume-title":"Pregnancy in Women with Type 1 and Type 2 Diabetes in 2002\u201303, England, Wales and Northern Ireland","author":"Confidential Enquiry into Maternal and Child Health (CEMACH)","year":"2005"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD001997"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-3016.2008.00980.x"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpobgyn.2010.10.006"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828X.2011.01378.x"}],"container-title":["Journal of Obstetrics and Gynaecology Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fjog.13605","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jog.13605","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T18:38:57Z","timestamp":1695494337000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/jog.13605"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,2,14]]},"references-count":31,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2018,5]]}},"alternative-id":["10.1111\/jog.13605"],"URL":"https:\/\/doi.org\/10.1111\/jog.13605","archive":["Portico"],"relation":{},"ISSN":["1341-8076","1447-0756"],"issn-type":[{"value":"1341-8076","type":"print"},{"value":"1447-0756","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,2,14]]}}}