title: Trends in pre-pregnancy diabetes among deliveries in 19 U.S. states, 2000-2010.
abstract: BACKGROUND
  Trends in state-level prevalence of pre-pregnancy diabetes mellitus (PDM; i.e., type 1 or type 2 diabetes diagnosed before pregnancy) among delivery hospitalizations are needed to inform healthcare delivery planning and prevention programs.
  
  
  OBJECTIVE
  To examine PDM trends overall, by age group, race/ethnicity, primary payer, and with comorbidities such as pre-eclampsia and pre-pregnancy hypertension, and to report changes in prevalence over 11 years.
  
  
  METHODS
  In 2014, State Inpatient Databases from the Agency for Healthcare Research and Quality were analyzed to identify deliveries with PDM and comorbidities using diagnosis-related group codes and ICD-9-CM codes. General linear regression with a log-link and binomial distribution was used to assess the annual change.
  
  
  RESULTS
  Between 2000 and 2010, PDM deliveries increased significantly in all age groups, all race/ethnicity groups, and in all states examined (p<0.01). The age-standardized prevalence of PDM increased from 0.65 per 100 deliveries in 2000 to 0.89 per 100 deliveries in 2010, with a relative change of 37% (p<0.01). Although PDM rates were highest in the South, some of the largest relative increases occurred in five Western states (≥69%). Non-Hispanic blacks had the highest PDM rates and the highest absolute increase (0.26 per 100 deliveries). From 2000 to 2010, the proportion of PDM deliveries with pre-pregnancy hypertension increased significantly (p<0.01) from 7.4% to 14.1%.
  
  
  CONCLUSIONS
  PDM deliveries are increasing overall and particularly among those with PDM who have hypertension. Effective diabetes prevention and control strategies for women of childbearing age may help protect their health and that of their newborns.
authors.affiliation: Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia. Electronic address: bfb7@cdc.gov.
authors.forename: Barbara H
authors.initials: BH
authors.lastname: Bardenheier
authors.affiliation: Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia.
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Imperatore
authors.affiliation: Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia.
authors.forename: Heather M
authors.initials: HM
authors.lastname: Devlin
authors.affiliation: Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia.
authors.forename: Shin Y
authors.initials: SY
authors.lastname: Kim
authors.affiliation: Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia.
authors.forename: Pyone
authors.initials: P
authors.lastname: Cho
authors.affiliation: Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia.
authors.forename: Linda S
authors.initials: LS
authors.lastname: Geiss
mesh_terms: D000293:Adolescent; D000328:Adult; D036861:Delivery, Obstetric; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008484:Medicaid / Q000706:statistics & numerical data; D011225:Pre-Eclampsia / Q000453:epidemiology; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000453:epidemiology*; D015995:Prevalence; D044469:Racial Groups / Q000706:statistics & numerical data; D014481:United States; D055815:Young Adult