Regional divergence and time trends in the prevalence of gestational diabetes mellitus: a national Danish cohort study.

Autor: Scheuer CM; Department of Gynaecology and Obstetrics, Nordsjællands Hospital, Hillerød, Denmark. cathrine.munk.scheuer.01@regionh.dk., Andersen MH; Department of Gynaecology and Obstetrics, Nordsjællands Hospital, Hillerød, Denmark., Mathiesen ER; Department of Endocrinology and Metabolism, Center for Pregnant Women with Diabetes, Copenhagen, Denmark.; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark., Ringholm L; Department of Endocrinology and Metabolism, Center for Pregnant Women with Diabetes, Copenhagen, Denmark., Müller CL; Department of Gynaecology and Obstetrics, Nordsjællands Hospital, Hillerød, Denmark., Truong JM; Department of Gynaecology and Obstetrics, Nordsjællands Hospital, Hillerød, Denmark., Lie-Olesen MM; Department of Gynaecology and Obstetrics, Nordsjællands Hospital, Hillerød, Denmark., Overgaard M; Department of Clinical Biochemistry, Odense University Hospital, Odense, Denmark.; Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark., McIntyre HD; Mater Clinical Unit, Faculty of Medicine, The University of Queensland, Brisbane, Australia., Jensen DM; Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark.; Department of Gynecology and Obstetrics, Odense University Hospital, Odense, Denmark.; Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark., Damm P; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.; Department of Obstetrics, Center for Pregnant Women with Diabetes, Rigshospitalet, Copenhagen, Denmark., Clausen TD; Department of Gynaecology and Obstetrics, Nordsjællands Hospital, Hillerød, Denmark.; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
Jazyk: angličtina
Zdroj: Acta diabetologica [Acta Diabetol] 2023 Mar; Vol. 60 (3), pp. 379-386. Date of Electronic Publication: 2022 Dec 20.
DOI: 10.1007/s00592-022-02013-8
Abstrakt: Aims: To evaluate the prevalence and time trends of gestational diabetes mellitus (GDM) across the five regions of Denmark with uniform national guidelines for screening and diagnosing GDM.
Methods: This register-based national cohort study included 287,684 births from 2013 to 2017. Trends in GDM prevalence over time and differences between the five regions were evaluated. Crude and adjusted odd ratios (ORs) for GDM were calculated including potential confounding clinical risk factors as age, BMI, educational level, marital status, parity, country of origin and assisted reproduction.
Results: From 2013 to 2017, GDM prevalence in Denmark increased by 7% per year (OR 1.07, 95% CI 1.06-1.09, P < 0.001). GDM prevalence varied considerably between regions and ranged from 3.0 to 5.9% in 2017, corresponding to a maximal regional difference of 97%. In crude analyses, the risk of GDM in 2017 was significantly different in four of five regions compared to the remaining regions (OR ranging from 0.60 to 1.55), and these differences persisted after adjusting for confounding clinical risk factors (adjusted OR: 0.59-1.45).
Conclusion: The prevalence of GDM increased over time in all Danish regions with substantial regional divergence. Up to a 97%, difference in GDM prevalence was observed between Danish regions, which was not explained by available clinical risk factors. This occurred despite national guidelines and raises the question of whether regional variations in screening efficacy, diagnostic procedures or inequality in clinical health care access may explain the observed differences.
(© 2022. The Author(s).)
Databáze: MEDLINE
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