Temporal trend of diabetes in pregnant women and its association with birth outcomes, 2011 to 2017

J Diabetes Complications. 2020 Apr;34(4):107550. doi: 10.1016/j.jdiacomp.2020.107550. Epub 2020 Jan 24.

Abstract

Aim: To assess changes in the prevalence of diabetes in pregnant women, and its association with selected birth outcomes (including caesarean section, episiotomy, admission to the special care nursery/neonatal intensive care unit, postpartum haemorrhage and neonatal birth weight) from 2011 to 2017.

Methods: In a single-centre, retrospective cohort study, we examined records of pregnant women who attended an Australian tertiary hospital between 2011 and 2017, identifying women with gestational diabetes mellitus and pre-existing diabetes mellitus, and examined trends associated with diabetes and their effects on birth outcomes.

Results: The average incidence of women with diabetes increased by 9% annually (RR = 0.09, 95% CI = 1.08-1.11), which was 6% greater in women who received antenatal doctor-led care (RR = 1.06, 95% CI = 1.01-1.13), 42% greater in women who had other endocrine diseases (including thyroid, adrenal or pituitary diseases) (RR = 1.42, 95% CI = 1.31-1.53), and 61% greater in women with hypertension during pregnancy (RR = 1.61, 95% CI = 1.47-1.78). The presence of diabetes did not affect the relative risks of caesarean section, episiotomy, postpartum haemorrhage, decreased neonatal birth weight or special care nursery/neonatal intensive care unit admission, after adjustment for demographics and health and care status and behaviours.

Conclusions: The rate of diabetes during pregnancy increased from 2011 to 2017. Diabetes did not affect the relative risk of untoward birth outcomes.

Keywords: Birth outcome; Gestational diabetes; Pre-existing diabetes; Pregnancy; Pregnant; Trend.

Publication types

  • Historical Article

MeSH terms

  • Adolescent
  • Adult
  • Australia / epidemiology
  • Birth Rate / trends
  • Cohort Studies
  • Diabetes, Gestational / epidemiology*
  • Female
  • History, 21st Century
  • Humans
  • Infant, Newborn
  • Middle Aged
  • Pregnancy
  • Pregnancy Outcome / epidemiology*
  • Pregnancy in Diabetics / epidemiology*
  • Retrospective Studies
  • Young Adult