Trends in pregnancy outcomes for women with gestational diabetes mellitus in Sweden 1998–2012: a nationwide cohort study

Abstract

Aim To assess whether incidence of maternal and neonatal outcomes for women with or without gestational diabetes mellitus (GDM) have changed over time. Methods Population-based cohort study in Sweden including all singleton pregnancies over the period 1998-2012. GDM was diagnosed following Diabetic Pregnancy Study Group 1991 criteria. Poisson regression or negative binomial regression was used to model yearly relative change in numbers of cases and incidence of the outcomes with 95% confidence intervals (CI), and yearly absolute change in birthweight z-score. Results The study included 1 455 667 pregnancies. The number of pregnancies increased over time and the overall prevalence of GDM was 1%. For women with GDM there was a significantly decreasing trend in incidence per year for large for gestational age (LGA) (0.986, 95% CI 0.975 to 0.996), birthweight z-score (À0.012, 95% CI À0.017 to À0.007) and birth trauma (0.937, 95% CI 0.907 to 0.968). The trend for small for gestational age (SGA) among women with GDM increased by an odds ratio per year (1.016, 95% CI 1.002 to 1.029). No significant interaction tests for maternal characteristics were found. Trends in outcomes for women without diabetes were similar to those for women with GDM. Conclusions This study shows that there were improvements in pregnancy outcomes for women with GDM between 1998 and 2012, although the incidence of SGA increased. Improvements followed similar trends in the background population. Inequalities in obstetric outcomes between women with GDM and those without have continued unchanged over 15 years, suggesting that new management strategies are required to reduce this gap.

Gestational weight gain influences neonatal outcomes in women with obesity and gestational diabetes

“…In addition, maternal age has been identi ed as another adverse factor, since its increase over the past years in high-income countries has been associated to a higher risk of GDM. In this regard, mean age in our cohort was almost 35 years, which is slightly higher than what has been reported in some previous studies [21][22][23], and this may have in uenced the total prevalence of obesity and GDM in our cohort.…”

Gestational diabetes mellitus and adverse pregnancy outcomes: systematic review and meta-analysis

“…The findings of the study showed that maternal hyperglycaemia independently increased the risk of preterm delivery, caesarean delivery, infants born large for gestational age, admission to a neonatal intensive care unit, neonatal hypoglycaemia, and hyperbilirubinaemia 6. The obstetric risks associated with diabetes, such as pregnancy induced hypertension, macrosomia, congenital malformations, and neonatal hypoglycaemia, have been reported in several large scale studies 789101112. The HAPO study did not adjust for some confounders, however, such as maternal body mass index, and did not report on stillbirths and neonatal respiratory distress syndrome, raising uncertainty about these outcomes.…”

“… 6 The obstetric risks associated with diabetes, such as pregnancy induced hypertension, macrosomia, congenital malformations, and neonatal hypoglycaemia, have been reported in several large scale studies. 7 8 9 10 11 12 The HAPO study did not adjust for some confounders, however, such as maternal body mass index, and did not report on stillbirths and neonatal respiratory distress syndrome, raising uncertainty about these outcomes. Other important pregnancy outcomes, such as preterm delivery, neonatal death, and low Apgar score in gestational diabetes mellitus, were poorly reported.…”

Association of maternal low‐carbohydrate‐diet score during pregnancy with allergic diseases at 2 years of age

“…Smoking was defined as smoking or exposure to secondhand smoke during pregnancy (yes, no), and history of allergy as any allergic diseases or symptoms ever diagnosed in pregnant women before and during pregnancy (yes, no). Gestational diabetes mellitus (GDM) was diagnosed according to the International Association of the Diabetes and Pregnancy Study Group (IADPSG; yes, no) 20 . Seasons of FFQ were defined as spring (March–May), summer (June–August), fall (September–November), and winter (December–February).…”