OBJECTIVE: To describe recent trends in the proportion of deliveries in women with pregestational diabetes (PGD), their use of services, and diabetes-related obstetrical complications. RESEARCH DESIGN AND METHODS: In this population-based retrospective cohort study, comprehensive administrative data were used to identify all women (with and without PGD) who gave birth in an Ontario, Canada, hospital from 1996 to 2001. Data on maternal complications and interventions were obtained from hospital discharge records; data on use of prenatal services were obtained from fee-for-service claims. RESULTS: The proportion of deliveries in women with PGD increased steadily from 0.8% in 1996 to 1.2% in 2001 (P < 0.001). In 2001, women with PGD were more likely to be diagnosed with shoulder dystocia (adjusted odds ratio 2.00 [95% CI 1.55-2.58]), hypertension (4.13 [3.44-4.96]), and preeclampsia/eclampsia (4.44 [3.43-5.73]) and have higher rates of inductions (1.69 [1.52-1.88]) and caesarean sections (1.78 [1.60-1.98]) than women without PGD. In 2001, 50% of the women with PGD had a visit to a diabetes specialist during pregnancy and only 30% of women had claims for a prenatal retinal examination. Both of these rates have decreased over the study period. CONCLUSIONS: Women with PGD now account for a larger proportion of deliveries. These women continue to have higher obstetrical complication and intervention rates than women without PGD and many do not receive recommended specialty care during pregnancy.
OBJECTIVE: To describe recent trends in the proportion of deliveries in women with pregestational diabetes (PGD), their use of services, and diabetes-related obstetrical complications. RESEARCH DESIGN AND METHODS: In this population-based retrospective cohort study, comprehensive administrative data were used to identify all women (with and without PGD) who gave birth in an Ontario, Canada, hospital from 1996 to 2001. Data on maternal complications and interventions were obtained from hospital discharge records; data on use of prenatal services were obtained from fee-for-service claims. RESULTS: The proportion of deliveries in women with PGD increased steadily from 0.8% in 1996 to 1.2% in 2001 (P < 0.001). In 2001, women with PGD were more likely to be diagnosed with shoulder dystocia (adjusted odds ratio 2.00 [95% CI 1.55-2.58]), hypertension (4.13 [3.44-4.96]), and preeclampsia/eclampsia (4.44 [3.43-5.73]) and have higher rates of inductions (1.69 [1.52-1.88]) and caesarean sections (1.78 [1.60-1.98]) than women without PGD. In 2001, 50% of the women with PGD had a visit to a diabetes specialist during pregnancy and only 30% of women had claims for a prenatal retinal examination. Both of these rates have decreased over the study period. CONCLUSIONS:Women with PGD now account for a larger proportion of deliveries. These women continue to have higher obstetrical complication and intervention rates than women without PGD and many do not receive recommended specialty care during pregnancy.
Authors: Boyd E Metzger; Steven G Gabbe; Bengt Persson; Thomas A Buchanan; Patrick A Catalano; Peter Damm; Alan R Dyer; Alberto de Leiva; Moshe Hod; John L Kitzmiler; Lynn P Lowe; H David McIntyre; Jeremy J N Oats; Yasue Omori; Maria Ines Schmidt Journal: Diabetes Care Date: 2010-03 Impact factor: 17.152
Authors: Maria P Vélez; Morgan Slater; Rebecca Griffiths; Baiju R Shah; Roseanne Sutherland; Carmen Jones; Kristen Jacklin; Jennifer D Walker; Michael E Green Journal: CMAJ Open Date: 2020-03-19
Authors: Jean M Lawrence; Susan E Andrade; Lyndsay A Avalos; Sarah J Beaton; Vicki Y Chiu; Robert L Davis; Sascha Dublin; Pamala A Pawloski; Marsha A Raebel; David H Smith; Sengwee Toh; Jean Q Wang; Sigal Kaplan; Thushi Amini; Christian Hampp; Tarek A Hammad; Pamela E Scott; T Craig Cheetham Journal: Obstet Gynecol Date: 2013-01 Impact factor: 7.661
Authors: Tina M Saldana; Olga Basso; Donna D Baird; Jane A Hoppin; Clarice R Weinberg; Aaron Blair; Michael C R Alavanja; Dale P Sandler Journal: Environ Health Perspect Date: 2009-06-04 Impact factor: 9.031