Prevalence of gestational diabetes mellitus, maternal obesity and associated perinatal outcomes over 10 years in an Australian tertiary maternity provider.


Journal

Diabetes research and clinical practice
ISSN: 1872-8227
Titre abrégé: Diabetes Res Clin Pract
Pays: Ireland
ID NLM: 8508335

Informations de publication

Date de publication:
Sep 2023
Historique:
received: 12 04 2023
revised: 08 06 2023
accepted: 14 06 2023
medline: 23 10 2023
pubmed: 22 6 2023
entrez: 21 6 2023
Statut: ppublish

Résumé

The International Association of Diabetes in Pregnancy Study Groups (IADPSG) gestational diabetes mellitus (GDM) criteria have been heavily scrutinised with concerns that the consequent GDM prevalence increase has not been associated with improved perinatal outcomes. At a tertiary hospital in Melbourne, Australia we aimed to evaluate prevalence trends for GDM, type 2 diabetes (T2DM), maternal obesity and large-for-gestational age (LGA) and assess changes in perinatal outcomes following IADPSG criteria uptake in 2015. A retrospective cohort study of singleton births from 20 weeks' gestation was conducted between 1st January 2011 and 31st December 2020. Maternal characteristics and perinatal outcomes were extracted from medical records. 52,795 pregnancies were included. GDM prevalence increased 2.7 times from 8.9% in 2011 to 23.7% in 2020 and increased annually by 8.59% (95%CI 7.77, 9.42). The rate of T2DM increased annually by 11.69% (95%CI 7.72, 16.67). Obesity prevalence increased annually by 3.18% (95%CI 2.58, 3.78). Induction of labour (IOL) prevalence increased annually by 8.35% (95%CI 5.69, 11.06). LGA prevalence remained unchanged. Increasing maternal obesity was the major contributing factor for LGA prevalence. From 2011 to 2020 GDM, obesity and T2DM prevalence increased significantly, with associated increased IOL, without change in LGA rates. Prospective studies are required to explore interactions between GDM, obesity, LGA and obstetric interventions.

Sections du résumé

BACKGROUND BACKGROUND
The International Association of Diabetes in Pregnancy Study Groups (IADPSG) gestational diabetes mellitus (GDM) criteria have been heavily scrutinised with concerns that the consequent GDM prevalence increase has not been associated with improved perinatal outcomes.
AIMS OBJECTIVE
At a tertiary hospital in Melbourne, Australia we aimed to evaluate prevalence trends for GDM, type 2 diabetes (T2DM), maternal obesity and large-for-gestational age (LGA) and assess changes in perinatal outcomes following IADPSG criteria uptake in 2015.
METHODS METHODS
A retrospective cohort study of singleton births from 20 weeks' gestation was conducted between 1st January 2011 and 31st December 2020. Maternal characteristics and perinatal outcomes were extracted from medical records.
RESULTS RESULTS
52,795 pregnancies were included. GDM prevalence increased 2.7 times from 8.9% in 2011 to 23.7% in 2020 and increased annually by 8.59% (95%CI 7.77, 9.42). The rate of T2DM increased annually by 11.69% (95%CI 7.72, 16.67). Obesity prevalence increased annually by 3.18% (95%CI 2.58, 3.78). Induction of labour (IOL) prevalence increased annually by 8.35% (95%CI 5.69, 11.06). LGA prevalence remained unchanged. Increasing maternal obesity was the major contributing factor for LGA prevalence.
CONCLUSIONS CONCLUSIONS
From 2011 to 2020 GDM, obesity and T2DM prevalence increased significantly, with associated increased IOL, without change in LGA rates. Prospective studies are required to explore interactions between GDM, obesity, LGA and obstetric interventions.

Identifiants

pubmed: 37343727
pii: S0168-8227(23)00556-9
doi: 10.1016/j.diabres.2023.110793
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

110793

Informations de copyright

Copyright © 2023 Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

J Deitch (J)

Department of Diabetes & Endocrinology, Western Health, St Albans, Victoria, Australia; Department of Medicine, University of Melbourne, Parkville, Victoria, Australia. Electronic address: jessica.deitch@wh.org.au.

C J Yates (CJ)

Department of Diabetes & Endocrinology, Western Health, St Albans, Victoria, Australia; Department of Medicine, University of Melbourne, Parkville, Victoria, Australia.

P S Hamblin (PS)

Department of Diabetes & Endocrinology, Western Health, St Albans, Victoria, Australia; Department of Medicine, University of Melbourne, Parkville, Victoria, Australia.

D Kevat (D)

Department of Diabetes & Endocrinology, Western Health, St Albans, Victoria, Australia; Department of Medicine, University of Melbourne, Parkville, Victoria, Australia; Department of Obstetric Medicine, Western Health, St Albans, Victoria, Australia.

I Shahid (I)

Department of Diabetes & Endocrinology, Western Health, St Albans, Victoria, Australia.

G Teale (G)

Department of Obstetrics & Gynaecology, Western Health, St Albans, Victoria, Australia.

I Lee (I)

Department of Diabetes & Endocrinology, Western Health, St Albans, Victoria, Australia; Department of Medicine, University of Melbourne, Parkville, Victoria, Australia.

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