Diabetes is one of the most common and fastest-growing comorbidities of pregnancy, according to a CDC study. Using Agency for Healthcare Research and Quality (AHRQ) databases for 19 states, the researchers found a 56% increase over 10 years in deliveries involving gestational diabetes mellitus (GDM): from 3.71 per 100 deliveries in 2000 to 5.77 per 100 deliveries in 2010. In that same time span, GDM deliveries increased significantly in all the study states, with relative increases ranging from 36% in Maryland to 88% in Utah.
Overall, the number of GDM deliveries increased by 59%, from 75,212 in 2000 to 119,229 in 2010 in the 19 states studied. In the states where ethnicity statistics were analyzed, the highest relative increase was among Hispanic patients. However, overall, non-Hispanic Asians had the highest prevalence of GDM. (IHS hospitals are not included in the AHRQ state data; the sample of Native Americans’ deliveries in community hospitals was too small to report.) Patients with prepregnancy hypertension were also increasingly likely to have a birth complicated by GDM. The greatest relative increase in GDM deliveries by age was among women aged 15 to 24 years.
During the study period, the proportion of GDM deliveries with comorbidities also rose significantly: prepregnancy hypertension increased 64%, from 2.5% to 4.1%, and preeclampsia increased 12%, from 9.8% to 11.0%.
Gestational diabetes mellitus has been associated with many adverse perinatal outcomes, such as larger-than-normal babies, leading to difficult labor and delivery and maternal morbidity. Moreover, GDM puts both mother and child at risk for type 2 DM. The researchers believe the rise in GDM deliveries can be directly linked to the rise in obesity across the U.S. Women who are obese are 4 to 8 times more likely to develop GDM, they note. The researchers advocate not only teaching about diabetes prevention and control, but also breast-feeding, which has been shown to mitigate the risk of type 2 DM, even in women who are obese or who have GDM, and their offspring.