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

Abstract

AimTo 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. MethodsIn 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. ResultsThe 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. ConclusionsThe rate of diabetes during pregnancy increased from 2011 to 2017. Diabetes did not affect the relative risk of untoward birth outcomes.