title: Impact of diabetes on maternal-fetal outcomes in Manitoba: Relationship with ethnic and environmental factors.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Universityof Manitoba, and Manitoba Health and Healthy Living4, Winnipeg, MB, Canada.
authors.forename: Naji
authors.initials: N
authors.lastname: Aljohani
authors.forename: Brenda M
authors.initials: BM
authors.lastname: Rempel
authors.forename: Sora
authors.initials: S
authors.lastname: Ludwig
authors.forename: Margaret
authors.initials: M
authors.lastname: Morris
authors.forename: Mary
authors.initials: M
authors.lastname: Cheang
authors.forename: Robert
authors.initials: R
authors.lastname: Murray
authors.forename: Sharon
authors.initials: S
authors.lastname: Bruce
authors.forename: Garry X
authors.initials: GX
authors.lastname: Shen
mesh_terms: 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