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Multicenter Study
. 2015 Jul;49(1):12-9.
doi: 10.1016/j.amepre.2015.01.026.

Trends in Gestational Diabetes Among Hospital Deliveries in 19 U.S. States, 2000-2010

Barbara H Bardenheier  1 , Giuseppina Imperatore  2 , Suzanne M Gilboa  3 , Linda S Geiss  2 , Sharon H Saydah  2 , Heather M Devlin  2 , Shin Y Kim  4 , Edward W Gregg  2
Affiliations
Multicenter Study

Trends in Gestational Diabetes Among Hospital Deliveries in 19 U.S. States, 2000-2010

Barbara H Bardenheier et al. Am J Prev Med. 2015 Jul.

Abstract

Introduction: Diabetes is one of the most common and fastest-growing comorbidities of pregnancy. Temporal trends in gestational diabetes mellitus (GDM) have not been examined at the state level. This study examines GDM prevalence trends overall and by age, state, and region for 19 states, and by race/ethnicity for 12 states. Sub-analysis assesses trends among GDM deliveries by insurance type and comorbid hypertension in pregnancy.

Methods: Using the Agency for Healthcare Research and Quality's National and State Inpatient Databases, deliveries were identified using diagnosis-related group codes for GDM and comorbidities using ICD-9-CM diagnosis codes among all community hospitals. General linear regression with a log-link and binomial distribution was used in 2014 to assess annual change in GDM prevalence from 2000 through 2010.

Results: The age-standardized prevalence of GDM increased from 3.71 in 2000 to 5.77 per 100 deliveries in 2010 (relative increase, 56%). From 2000 through 2010, GDM deliveries increased significantly in all states (p<0.01), with relative increases ranging from 36% to 88%. GDM among deliveries in 12 states reporting race and ethnicity increased among all groups (p<0.01), with the highest relative increase in Hispanics (66%). Among GDM deliveries in 19 states, those with pre-pregnancy hypertension increased significantly from 2.5% to 4.1% (relative increase, 64%). The burden of GDM delivery payment shifted from private insurers (absolute decrease of 13.5 percentage points) to Medicaid/Medicare (13.2-percentage point increase).

Conclusions: Results suggest that GDM deliveries are increasing. The highest rates of increase are among Hispanics and among GDM deliveries complicated by pre-pregnancy hypertension.

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Conflict of interest statement

No potential conflicts of interest relevant to this article were reported.

Figures

Figure 1
Figure 1
Crude and age- and race-standardized rates of gestational diabetes mellitus (GDM), 12 states: 2000–2010.
Figure 2
Figure 2
Proportion of gestational diabetes mellitus deliveries with hypertension, 19 states: 2000–2010.
Figure 3
Figure 3
Proportion of gestational diabetes mellitus deliveries by expected primary payer, 19 states: 2000–2010.
See this image and copyright information in PMC

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