title: Prevalence of gestational diabetes and risk of complications before and after initiation of a general systematic two-step screening strategy in Germany (2012-2014).
abstract: OBJECTIVE
  Information on the prevalence of gestational diabetes mellitus is scarce on national and international level. On July 1st, 2013, a general two-step screening was implemented in Germany harmonizing gestational diabetes diagnoses. We aim to provide prevalence estimates for gestational diabetes and pregnancy-related complications for the large region of North Rhine for the 12 months before and after introduction of the general screening.
  
  
  METHODS
  Routine care data covering all outpatient diagnoses of more than 150,000 pregnancies per 12-month period in women aged 15-55 years was used to determine cases of gestational diabetes. Gestational diabetes diagnosis and pregnancy-related complications were assessed according to the International Statistical Classification of Diseases and Related Health Problems (ICD-10). Relative Risks for pregnancy-related complications were calculated in pregnancies with and without gestational diabetes.
  
  
  RESULTS
  Before the screening, diagnosis of gestational diabetes was made in 6.02% of pregnancies and in 6.81% after this date (other types of diabetes mellitus: 1.67% and 1.76% respectively). The prevalence of GDM increased with age and was highest at age 36-40 years (8.45%). The relative increase in prevalence after introduction of the screening was highest in the age group≤25 years (24.9%). The frequency of pregnancy-related complications such as hypertension, pre-eclampsia, cesarean section was increased in pregnancies with gestational diabetes in comparison to those without independent of observation period.
  
  
  CONCLUSIONS
  We found a high prevalence of gestational diabetes, which has relatively increased by 13.12% after the introduction of the general screening.
authors.affiliation: Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany. Electronic address: teresa.tamayo@ddz.uni-duesseldorf.de.
authors.forename: T
authors.initials: T
authors.lastname: Tamayo
authors.affiliation: Kassenärztliche Vereinigung Nordrhein, Düsseldorf, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Tamayo
authors.affiliation: Institute of Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Rathmann
authors.affiliation: Kassenärztliche Vereinigung Nordrhein, Düsseldorf, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Potthoff
mesh_terms: D000293:Adolescent; D000328:Adult; D016640:Diabetes, Gestational / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005858:Germany / Q000453:epidemiology; D005951:Glucose Tolerance Test; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D011225:Pre-Eclampsia / Q000175:diagnosis / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D015995:Prevalence; D012307:Risk Factors; D055815:Young Adult
keywords: Gestational diabetes; Nationwide strategy; Oral glucose tolerance test; Pregnancy-related complications; Routine care; Two-step screening