Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee, USA.
Diabetes Care. 2010 Apr;33(4):768-73. doi: 10.2337/dc09-1801. Epub 2010 Jan 12.
To examine trends in the prevalence of diabetes among delivery hospitalizations in the U.S. and to describe the characteristics of these hospitalizations.
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.
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]).
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.
在美国，研究分娩住院患者中糖尿病患病率的变化趋势，并描述这些住院患者的特点。
从 1994 年至 2004 年，我们从全国住院患者样本中获取了住院分娩数据。选择了妊娠糖尿病（GDM）、1 型糖尿病、2 型糖尿病和未特指糖尿病的诊断代码。每 100 例分娩计算糖尿病分娩住院率。
在这 11 年期间，估计有 1863746 例分娩住院患者的诊断中包含糖尿病，相应的糖尿病分娩率为每 100 例分娩 4.3 例。GDM 占糖尿病分娩住院患者的最大比例（84.7%），其次是 1 型（7%）、2 型（4.7%）和未特指糖尿病（3.6%）。1994 年至 2004 年，所有糖尿病、GDM、1 型糖尿病和 2 型糖尿病的发生率在总体上以及每个年龄组（15-24 岁、25-34 岁和≥35 岁）中均显著增加（P＜0.05）。所有年龄段中，2 型糖尿病的增幅最大（367%）。按年龄组划分，每种糖尿病类型中，最大的百分比增幅均见于两个年轻年龄组。分娩时发生糖尿病的显著预测因素包括年龄≥35 岁与 15-24 岁（比值比 4.80[95%CI 4.72-4.89]）、城市与农村地区（1.14[1.11-1.17]）以及医疗补助/医疗保险与其他支付来源（1.29[1.26-1.32]）。
鉴于分娩住院患者中糖尿病的患病率不断增加，尤其是在年轻女性中，因此监测妊娠人群的趋势并制定策略以最大限度地降低母婴/胎儿并发症的风险将非常重要。
