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Article

A Population-Based Study of Diabetes during Pregnancy in Spain (2009–2015): Trends in Incidence, Obstetric Interventions, and Pregnancy Outcomes

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Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, 28922 Madrid, Spain
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Public Health and Psychiatry Department, Faculty of Medicine, Universidad de Malaga, 29071 Malaga, Spain
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Basic Science Department, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, 28922 Madrid, Spain
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Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
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Respiratory Department, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), 28009 Madrid, Spain
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Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(2), 582; https://doi.org/10.3390/jcm9020582
Received: 11 January 2020 / Revised: 13 February 2020 / Accepted: 18 February 2020 / Published: 21 February 2020
(This article belongs to the Section Obstetrics & Gynecology)
(1) Background: We examined trends in incidence and outcomes in women with existing type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM) and gestational diabetes mellitus (GDM) compared with a control group without diabetes. (2) Methods: This was an observational, retrospective epidemiological study using the National Hospital Discharge Database. (3) Results: There were 2,481,479 deliveries in Spain between 2009 and 2015 (5561 mothers with T1DM, 4391 with T2DM, and 130,980 with GDM). Incidence and maternal age of existing diabetes and GDM increased over time. Women with T2DM were more likely to have obstetric comorbidity (70.12%) than those with GDM (60.28%), T1DM (59.45%), and no diabetes (41.82%). Previous cesarean delivery, preeclampsia, smoking, hypertension, and obesity were the most prevalent risk factors in all types of diabetes. Women with T1DM had the highest rate of cesarean delivery (Risk Ratio (RR) 2.34; 95% Confidence Interval (CI) 2.26–2.43) and prolonged maternal length of stay. Labor induction was higher in T2DM (RR 1.99; 95% CI 1.89–2.10). Women with T1DM had more severe maternal morbidity (RR 1.97; 95% CI 1.70–2.29) and neonatal morbidity (preterm birth, RR 3.32; 95% CI 3.14–3.51, and fetal overgrowth, RR 8.05; 95% CI 7.41–8.75). (4) Conclusions: existing and GDM incidence has increased over time. We found differences in the prevalence of comorbidities, obstetric risk factors, and the rate of adverse obstetric outcomes among women with different types of diabetes. Pregnant women with diabetes have the highest risk of adverse pregnancy outcomes. View Full-Text
Keywords: gestational diabetes mellitus; type 1 diabetes mellitus; type 2 diabetes mellitus; pregnancy; hospitalizations; outcomes gestational diabetes mellitus; type 1 diabetes mellitus; type 2 diabetes mellitus; pregnancy; hospitalizations; outcomes
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MDPI and ACS Style

López-de-Andrés, A.; Perez-Farinos, N.; Hernández-Barrera, V.; Palomar-Gallego, M.A.; Carabantes-Alarcón, D.; Zamorano-León, J.J.; De Miguel-Diez, J.; Jimenez-Garcia, R. A Population-Based Study of Diabetes during Pregnancy in Spain (2009–2015): Trends in Incidence, Obstetric Interventions, and Pregnancy Outcomes. J. Clin. Med. 2020, 9, 582. https://doi.org/10.3390/jcm9020582

AMA Style

López-de-Andrés A, Perez-Farinos N, Hernández-Barrera V, Palomar-Gallego MA, Carabantes-Alarcón D, Zamorano-León JJ, De Miguel-Diez J, Jimenez-Garcia R. A Population-Based Study of Diabetes during Pregnancy in Spain (2009–2015): Trends in Incidence, Obstetric Interventions, and Pregnancy Outcomes. Journal of Clinical Medicine. 2020; 9(2):582. https://doi.org/10.3390/jcm9020582

Chicago/Turabian Style

López-de-Andrés, Ana, Napoleón Perez-Farinos, Valentín Hernández-Barrera, María A. Palomar-Gallego, David Carabantes-Alarcón, José J. Zamorano-León, Javier De Miguel-Diez, and Rodrigo Jimenez-Garcia. 2020. "A Population-Based Study of Diabetes during Pregnancy in Spain (2009–2015): Trends in Incidence, Obstetric Interventions, and Pregnancy Outcomes" Journal of Clinical Medicine 9, no. 2: 582. https://doi.org/10.3390/jcm9020582

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