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Observational Study
. 2014 Nov 14;4(11):e005394.
doi: 10.1136/bmjopen-2014-005394.

A population-based observational study of diabetes during pregnancy in Victoria, Australia, 1999-2008

Marian Abouzeid  1 , Vincent L Versace  2 , Edward D Janus  3 , Mary-Ann Davey  4 , Benjamin Philpot  2 , Jeremy Oats  5 , James A Dunbar  2
Affiliations
Observational Study

A population-based observational study of diabetes during pregnancy in Victoria, Australia, 1999-2008

Marian Abouzeid et al. BMJ Open. .

Abstract

Objectives: This paper reports secular trends in diabetes in pregnancy in Victoria, Australia and examines the effect of including or excluding women with pre-existing diabetes on gestational diabetes (GDM) prevalence estimates.

Design: Population-based observational study.

Setting: All births in Victoria, Australia between 1999 and 2008 PARTICIPANTS: 634,932 pregnancies resulting in a birth registered with the Victorian Perinatal Data Collection

Outcome measures: Crude and age-standardised secular trends in pre-existing diabetes and GDM prevalence; secular GDM trends by maternal birthplace; effects on GDM prevalence of including and excluding pre-existing diabetes from the denominator.

Results: Of the 634,932 pregnancies, 2954 (0.5%) occurred in women with pre-existing diabetes and 29,147 (4.6%) were complicated by GDM. Mean maternal age increased from 29.7 years in 1999 to 30.8 years in 2008. GDM prevalence increased in most maternal age groups. In 2008, age-standardised GDM prevalence was 31% higher than in 1999; secular increases were greater for Australian-born non-Indigenous (29% increase) than immigrant women (12.3% increase). The annual number of pregnancies in women with pre-existing diabetes almost doubled from 1999 to 2008 and prevalence increased from 0.4% to 0.6%. However, including or excluding pre-existing diabetes had little effect on GDM prevalence estimates.

Conclusions: Pre-existing diabetes and GDM prevalence increased in Victoria between 1999 and 2008 and rising maternal age does not fully explain these trends. These findings have important implications for preventive initiatives. Including or excluding small numbers of women with pre-existing diabetes resulted in minimal changes in GDM estimates. As pre-existing diabetes in young women increases, this methodological issue will likely become important.

Keywords: PREVENTIVE MEDICINE; PUBLIC HEALTH.

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Figures

Figure 1
Figure 1
(A) Crude and age-standardised prevalence of pre-existing maternal diabetes in pregnancy by year of delivery, Victoria 1999–2008; (B) Crude number of GDM cases by year of delivery and maternal age group, Victoria 1999–2008; (C) Crude GDM prevalence rates* by year of delivery and maternal age group, Victoria 1999–2008. *The denominator used to calculate prevalence of GDM is all pregnancies.
Figure 2
Figure 2
Age-standardised GDM prevalence rates* by maternal region of birth and year of delivery, Victoria 1999–2008. *The denominator used to calculate prevalence of GDM is all pregnancies.
See this image and copyright information in PMC

References

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