title: Reported prevalence of gestational diabetes in Scotland: The relationship with obesity, age, socioeconomic status, smoking and macrosomia, and how many are we missing?
abstract: OBJECTIVE
  Gestational diabetes mellitus (GDM) is defined as 'carbohydrate intolerance of varying degrees of severity with onset or first recognition during pregnancy,' and is associated with increased fetal and maternal risks. The aims of the present study were to investigate the prevalence of GDM in Scotland over 32 years (1981-2012), and using the data from 2012, to assess how GDM related to maternal body mass index, maternal age, parity, smoking, Scottish Index of Multiple Deprivation, infant gender and macrosomia status.
  
  
  METHODS
  GDM prevalence along with anthropometric, obstetric and demographic data were collected on a total of 1,891,097 women with a delivery episode between 1 January 1981 and 31 December 2012 using data extracted from the Scottish Morbidity Record 02. Univariate and multivariate logistic regression analysis was undertaken to investigate their association with GDM.
  
  
  RESULTS
  A ninefold increase in GDM prevalence was observed from 1981 to 2012 (P < 0.001). GDM prevalence in 2012 was 1.9%. Maternal body mass index, age, parity status, Scottish index of multiple deprivation and fetal macrosomia were positively associated with GDM. Reported smoking status at booking was inversely associated with GDM. Multivariable analysis showed that fetal macrosomia was not associated with GDM status.
  
  
  CONCLUSIONS
  The present study confirmed that the reporting of GDM is low in Scotland, and that GDM is associated with maternal body mass index, maternal age, multiparity and social deprivation. GDM was negatively associated with smoking and requires further investigation. The lack of association between GDM and macrosomia (following multivariate analysis) might reflect the screening processes undertaken in Scotland.
authors.affiliation: University Hospital Ayr, Ayr, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Collier
authors.affiliation: Institute for Applied Health Research, Institute for Society and Social Justice Research, Glasgow, Scotland, UK.
authors.forename: E Christie
authors.initials: EC
authors.lastname: Abraham
authors.affiliation: School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK.
authors.forename: Julie
authors.initials: J
authors.lastname: Armstrong
authors.affiliation: Institute for Applied Health Research, Institute for Society and Social Justice Research, Glasgow, Scotland, UK.
authors.forename: Jon
authors.initials: J
authors.lastname: Godwin
authors.affiliation: ISD Scotland, Edinburgh, UK.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Monteath
authors.affiliation: Institute of C&MS, BHF GCRC, Glasgow University, Glasgow, Scotland, UK.
authors.forename: Robert
authors.initials: R
authors.lastname: Lindsay
mesh_terms: D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D048909:Diabetes Complications / Q000453:epidemiology*; D016640:Diabetes, Gestational / Q000453:epidemiology*; D005260:Female; D005320:Fetal Macrosomia / Q000150:complications / Q000453:epidemiology; D006801:Humans; D011247:Pregnancy; D015995:Prevalence; D012606:Scotland / Q000453:epidemiology; D012907:Smoking / Q000009:adverse effects; D012923:Social Class; D055815:Young Adult
keywords: Body mass index; Gestational diabetes mellitus; Macrosomia