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Cited by 53Gestational Diabetes Research and ManagementPregnancy and Medication ImpactDiabetes Management and Research

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

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López-de-Andrés, Ana, Perez-Farinos, Napoleón, Hernández-Barrera, Valentín, Palomar-Gallego, María A., Carabantes-Alarcón, David, Zamorano-León, José J., De Miguel-Diez, Javier, Jimenez-Garcia, Rodrigo·2020·Journal of Clinical Medicine
DOI 10.3390/jcm9020582PMC PMC7074053
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Abstract

(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.

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  • In Spain, a population-based study using DDG criteria between 2009 and 2015 assessed gestational diabetes mellitus at 5.27%.

    “López-de-Andrés et al. in a population-based study performed between 2009 and 2015 using the DDG criteria assessed GDM at 5.27% [106].”

    From Evolution of Gestational Diabetes Mellitus across Continents in 21st Century (2022) · cites this paper as [106]

    The Results report 130,980 gestational-diabetes deliveries among 2,481,479 deliveries in Spain during 2009–2015, approximately 5.28%, close to the claimed 5.27%. But Materials and Methods (§2.1; page unavailable) says the study classified cases using ICD-9-CM discharge codes and describes Spanish screening recommendations; it does not say the study used DDG criteria. (LLM, conf=0.88)

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Authors
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.
Affiliations
  • Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, 28922 Madrid, Spain
  • Public Health and Psychiatry Department, Faculty of Medicine, Universidad de Malaga, 29071 Malaga, Spain
  • Basic Science Department, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, 28922 Madrid, Spain
  • Universidad Complutense de Madrid (ES)
  • Department of Public Health & Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
  • Respiratory Department, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), 28009 Madrid, Spain
ORCID
Venue
Journal of Clinical Medicine
Publisher
MDPI AG
Published
2020-02-21
Volume
9
Issue
2
Pages
582
ISSN
2077-0383 (ISSN-L)
DOI
10.3390/jcm9020582
PMC
PMC7074053
OpenAlex
W3008107134
Cited by
53
References
0
Citations by year
2026: 6 · 2025: 6 · 2024: 14 · 2023: 5 · 2022: 10 · 2021: 8 · 2020: 3
FWCI
3.98
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Clinical Medicine (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Docta Complutense (Universidad Complutense de Madrid) (submittedVersion, cc-by)
  • BURJC Digital (King Juan Carlos University) (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Hispana (submittedVersion, cc-by)
Funders
the FIS (Fondo de Investigaciones Sanitarias—Health Research Fund, Instituto de Salud Carlos III) and co-financed by the European Union through the Fondo Europeo de Desarrollo Regional (FEDER, “Una manera de hacer Europa”) (PI16/00564)
Topics
  • Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pregnancy and Medication Impact
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Keywords
diabetes in pregnancy, gestational diabetes mellitus, type 1 diabetes, type 2 diabetes, incidence trends, obstetric surgery, cesarean section, labor induction, maternal morbidity, neonatal morbidity, preterm birth, macrosomia, risk factors, Spain

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