Impact of diabetes on maternal-fetal outcomes in Manitoba: Relationship with ethnic and environmental factors.
OBJECTIVE
To examine the impact of gestational diabetes mellitus (GDM) on maternal-fetal outcomes in Manitoba.


METHODS
The rates of macrosomia, stillbirth, cesarean section (C/S) and shoulder dystocia (S/D) in 324,605 births in Manitoba during 1985-2004, and their relationships with diabetes and demographical factors were analyzed.


RESULTS
The incidence of macrosomia, stillbirth, C/S and S/D were 15.3%, 0.57%, 16.0%, and 1.2%, respectively. The rates of macrosomia were elevated in mothers with GDM, type 2 DM (T2DM), rural living, First Nations (FN) status, or >or=35 years of age. Increased rates of stillbirth were associated with women with T2DM, FN status or >or=35 years, but not those with GDM. C/S and S/D were increased in women with GDM or T2DM. FN status in combination with GDM increased the risk of S/D.


CONCLUSIONS
GDM, T2DM, advanced maternal age, FN status or rural living affected pregnancy outcomes in Manitoba.
Aljohani
Naji
N
Department of Internal Medicine, Universityof Manitoba, and Manitoba Health and Healthy Living4, Winnipeg, MB, Canada.
Rempel
Brenda M
BM
Ludwig
Sora
S
Morris
Margaret
M
Cheang
Mary
M
Murray
Robert
R
Bruce
Sharon
S
Shen
Garry X
GX
D000328:Adult; D000367:Age Factors; D001724:Birth Weight; D002585:Cesarean Section / Q000706:statistics & numerical data; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology; D016640:Diabetes, Gestational / Q000453:epidemiology* / Q000208:ethnology; D004420:Dystocia / Q000453:epidemiology; D004777:Environment; D005260:Female; D005320:Fetal Macrosomia / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008350:Manitoba / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000208:ethnology; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012307:Risk Factors; D012424:Rural Population / Q000706:statistics & numerical data; D050497:Stillbirth / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data