Diabetes trends among delivery hospitalizations in the U.S., 1994-2004.
OBJECTIVE
To examine trends in the prevalence of diabetes among delivery hospitalizations in the U.S. and to describe the characteristics of these hospitalizations.


METHODS
Hospital discharge data from 1994 through 2004 were obtained from the Nationwide Inpatient Sample. Diagnosis codes were selected for gestational diabetes mellitus (GDM), type 1 diabetes, type 2 diabetes, and unspecified diabetes. Rates of delivery hospitalization with diabetes were calculated per 100 deliveries.


RESULTS
Overall, an estimated 1,863,746 hospital delivery discharges contained a diabetes diagnosis, corresponding to a rate of 4.3 per 100 deliveries over the 11-year period. GDM accounted for the largest proportion of delivery hospitalizations with diabetes (84.7%), followed by type 1 (7%), type 2 (4.7%), and unspecified diabetes (3.6%). From 1994 to 2004, the rates for all diabetes, GDM, type 1 diabetes, and type 2 diabetes significantly increased overall and within each age-group (15-24, 25-34, and > or =35 years) (P < 0.05). The largest percent increase for all ages was among type 2 diabetes (367%). By age-group, the greatest percent increases for each diabetes type were among the two younger groups. Significant predictors of diabetes at delivery included age > or =35 years vs. 15-24 years (odds ratio 4.80 [95% CI 4.72-4.89]), urban versus rural location (1.14 [1.11-1.17]), and Medicaid/Medicare versus other payment sources (1.29 [1.26-1.32]).


CONCLUSIONS
Given the increasing prevalence of diabetes among delivery hospitalizations, particularly among younger women, it will be important to monitor trends in the pregnant population and target strategies to minimize risk for maternal/fetal complications.
Albrecht
Sandra S
SS
Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, USA. ssalb@umich.edu
Kuklina
Elena V
EV
Bansil
Pooja
P
Jamieson
Denise J
DJ
Whiteman
Maura K
MK
Kourtis
Athena P
AP
Posner
Samuel F
SF
Callaghan
William M
WM
D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D011247:Pregnancy; D014481:United States / Q000453:epidemiology