Trends in prevalence of pre-existing diabetes and perinatal outcomes : a large, population-based study in Catalonia, Spain, 2006-2015
Gortazar, Lucia (Universitat Autònoma de Barcelona. Departament de Medicina)
Goday Arnó, Albert (Universitat Autònoma de Barcelona. Departament de Medicina)
Flores-Le Roux, Juana Antonia (Universitat Autònoma de Barcelona. Departament de Medicina)
Sarsanedas, Eugènia (Hospital del Mar (Barcelona, Catalunya))
Payà, Antonio (Hospital del Mar (Barcelona, Catalunya))
Mañé, Laura (Universitat Autònoma de Barcelona. Departament de Medicina)
Pedro-Botet, Juan (Institut Hospital del Mar d'Investigacions Mèdiques)
Benaiges, David (Universitat Autònoma de Barcelona. Departament de Medicina)

Data:	2020
Resum:	This study aims to assess trends in the prevalence of pre-existing diabetes and whether the risk of adverse perinatal outcomes decreased in women between 2006 and 2015 in Catalonia, Spain. A population-based study of 743 762 singleton deliveries between 2006 and 2015 in Catalonia, Spain, was conducted using data from the Spanish Minimum Basic Data Set. Cases of type 1 diabetes (T1DM) and 'type 2 diabetes and other pre-existing diabetes' ('T2DM and other PGD') were identified using International Classification of Diseases, Ninth Revision, Clinical Modification codes. Crude and age-adjusted annual prevalences were calculated. Poisson regression model was used to assess trends in prevalence and perinatal outcomes during the study period. Overall prevalences of pre-existing diabetes, T1DM and 'T2DM and other PGD' were 0. 52% (95% CI 0. 51 to 0. 54), 0. 17% (95% CI 0. 17 to 0. 18) and 0. 35% (95% CI 0. 33 to 0. 36), respectively. From 2006 to 2015, rates increased for pre-existing diabetes (from 0. 43 (95% CI 0. 39 to 0. 48) to 0. 56% (0. 50 to 0. 62), p<0. 001), T1DM (from 0. 14 (0. 11 to 0. 17) to 0. 20% (0. 17 to 0. 23), p<0. 001) and 'T2DM and other PGD' (from 0. 29 (0. 25 to 0. 33) to 0. 36% (0. 31 to 0. 40), p<0. 001). Pre-eclampsia rose in women with pre-existing diabetes (from 4. 38% to 8. 97%, adjusted p<0. 001), T1DM (from 3. 85% to 12. 88%, p=0. 005) and 'T2DM and other PGD' (from 4. 63% to 6. 78%, adjusted p=0. 01). Prevalence of prematurity, cesarean section and small for gestational age remained stable in all diabetes groups. However, the prevalence of macrosomia fell in women with pre-existing diabetes (from 18. 18% to 11. 9%, adjusted p=0. 011) and 'T2DM and other PGD' (from 14. 71% to 11. 06%, non-adjusted p=0. 022, adjusted p=0. 305) and large for gestational age decreased in all diabetes groups (from 39. 73% to 30. 25% in pre-existing diabetes, adjusted p=0. 004). The prevalence of pre-existing diabetes increased significantly in Catalonia between 2006 and 2015. Despite improvements in outcomes related to excessive birth weight, pre-eclampsia rates are rising and overall perinatal outcomes in women with pre-existing diabetes continue to be markedly worse than in the population without diabetes.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Pregestational diabetes ; Maternal outcome ; Birth outcomes ; Epidemiology
Publicat a:	BMJ open diabetes research and care, Vol. 8 num. 1 (2020) art. 001254, ISSN 2052-4897

DOI: 10.1136/bmjdrc-2020-001254
PMID: 33106331

8 p, 962.6 KB

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