title: Prevalence of Adverse Pregnancy Outcomes, by Maternal Diabetes Status at First and Second Deliveries, Massachusetts, 1998-2007.
abstract: BACKGROUND
  Understanding patterns of diabetes prevalence and diabetes-related complications across pregnancies could inform chronic disease prevention efforts. We examined adverse birth outcomes by diabetes status among women with sequential, live singleton deliveries.
  
  
  METHODS
  We used data from the 1998-2007 Massachusetts Pregnancy to Early Life Longitudinal Data System, a population-based cohort of deliveries. We restricted the sample to sets of parity 1 and 2 deliveries. We created 8 diabetes categories using gestational diabetes mellitus (GDM) and chronic diabetes mellitus (CDM) status for the 2 deliveries. Adverse outcomes included large for gestational age (LGA), macrosomia, preterm birth, and cesarean delivery. We computed prevalence estimates for each outcome by diabetes status.
  
  
  RESULTS
  We identified 133,633 women with both parity 1 and 2 deliveries. Compared with women who had no diabetes in either pregnancy, women with GDM or CDM during any pregnancy had increased risk for adverse birth outcomes; the prevalence of adverse outcomes was higher in parity 1 deliveries among women with no diabetes in parity 1 and GDM in parity 2 (for LGA [8.5% vs 15.1%], macrosomia [9.7% vs. 14.9%], cesarean delivery [24.7% vs 31.3%], and preterm birth [7.7% vs 12.9%]); and higher in parity 2 deliveries among those with GDM in parity 1 and no diabetes in parity 2 (for LGA [12.3% vs 18.2%], macrosomia [12.3% vs 17.2%], and cesarean delivery [27.0% vs 37.9%]).
  
  
  CONCLUSIONS
  Women with GDM during one of 2 sequential pregnancies had elevated risk for adverse outcomes in the unaffected pregnancy, whether the diabetes-affected pregnancy preceded or followed it.
authors.affiliation: Centers for Disease Control and Prevention, 4770 Buford Highway NE, MS F74, Atlanta, GA 30341. Email: skim1@cdc.gov.
authors.forename: Shin Y
authors.initials: SY
authors.lastname: Kim
authors.affiliation: MassGeneral Hospital for Children and Harvard Medical School, Boston, Massachusetts.
authors.forename: Milton
authors.initials: M
authors.lastname: Kotelchuck
authors.affiliation: DB Consulting Group, Inc, Silver Spring, Maryland.
authors.forename: Hoyt G
authors.initials: HG
authors.lastname: Wilson
authors.affiliation: Bureau of Family Health and Nutrition, Department of Public Health, Boston, Massachusetts.
authors.forename: Hafsatou
authors.initials: H
authors.lastname: Diop
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Carrie K
authors.initials: CK
authors.lastname: Shapiro-Mendoza
authors.affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Lucinda J
authors.initials: LJ
authors.lastname: England
mesh_terms: D000328:Adult; D001724:Birth Weight; D002585:Cesarean Section / Q000706:statistics & numerical data; D016640:Diabetes, Gestational / Q000453:epidemiology*; D005260:Female; D005320:Fetal Macrosomia / Q000453:epidemiology; D006801:Humans; D008404:Massachusetts / Q000453:epidemiology; D010298:Parity; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000453:epidemiology; D015995:Prevalence; D012306:Risk; D055815:Young Adult