Bardenheier Barbara H, Imperatore Giuseppina, Devlin Heather M, Kim Shin Y, Cho Pyone, Geiss Linda S
Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia.
Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, CDC, Atlanta, Georgia.
Am J Prev Med. 2015 Feb;48(2):154-161. doi: 10.1016/j.amepre.2014.08.031. Epub 2014 Oct 14.
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.
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.
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.
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%.
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.
了解分娩住院患者中孕前糖尿病（PDM，即妊娠前诊断的1型或2型糖尿病）的州级流行趋势，有助于为医疗服务规划和预防项目提供信息。
总体上，按年龄组、种族/族裔、主要支付方以及是否伴有先兆子痫和孕前高血压等合并症，研究PDM流行趋势，并报告11年间患病率的变化情况。
2014年，对医疗保健研究与质量局的州住院数据库进行分析，使用诊断相关组代码和ICD-9-CM代码识别患有PDM和合并症的分娩病例。采用对数链接和二项分布的广义线性回归评估年度变化。
2000年至2010年期间，所有年龄组、所有种族/族裔组以及所有研究州的PDM分娩病例均显著增加（p<0.01）。PDM的年龄标准化患病率从2000年每100例分娩中的0.65例增至2010年的0.89例，相对变化为37%（p<0.01）。尽管南方的PDM发生率最高，但一些相对增幅最大的情况出现在五个西部州（≥69%）。非西班牙裔黑人的PDM发生率最高，绝对增幅也最大（每100例分娩增加0.26例）。2000年至2010年，伴有孕前高血压的PDM分娩病例比例从7.4%显著增至14.1%（p<0.01）。
总体而言，PDM分娩病例在增加，尤其是伴有高血压的PDM患者。针对育龄妇女的有效糖尿病预防和控制策略可能有助于保护她们及其新生儿的健康。
