Lynch Cheryl P, Baker Nathaniel, Korte Jeffrey E, Mauldin Jill G, Mayorga Maria E, Hunt Kelly J
1 Department of Medicine, Medical University of South Carolina , Charleston, South Carolina.
J Womens Health (Larchmt). 2015 Apr;24(4):316-23. doi: 10.1089/jwh.2014.4968. Epub 2015 Mar 18.
The objective of our study was to examine the prevalence of diabetes during pregnancy at the population level in SC from January 1996 through December 2008.
The study included 387,720 non-Hispanic white (NHW), 232,278 non-Hispanic black (NHB), and 43,454 Hispanic live singleton births. Maternal inpatient hospital discharge codes from delivery (91.59%) and prenatal information (i.e., Medicaid [42.91%] and SC State Health Plan [SHP] [5.98%]) were linked to birth certificate data. Diabetes during pregnancy included gestational and preexisting, defined by prenatal and maternal inpatient International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnostic codes (i.e., 64801-64802, 64881-64882, or 25000-25092) or report on the birth certificate.
Diabetes prevalence from any source increased from 5.02% (95% confidence interval [CI]: 4.82-5.22) in 1996 to 8.37% (95% CI: 8.15-8.60) in 2008. Diabetes prevalence, standardized for maternal age and race/ethnicity from 1996 through 2008, increased from 3.38% (95% CI: 3.29-3.47) to 5.81% (95% CI: 5.71-5.91) using birth certificate data, from 3.99% (95% CI: 3.89-4.10) to 6.69% (95% CI: 6.58-6.80) using hospital discharge data, and from 4.74% (95% CI: 4.52-4.96) to 8.82% (95% CI: 8.61-9.03) using Medicaid data. Comparing birth certificate to hospital discharge, Medicaid, and SHP data, Cohen's kappa in 2008 was 0.73 (95% CI: 0.72-0.75), 0.64 (95% CI: 0.62-0.66), and 0.59 (95% CI: 0.54-0.65), respectively.
An increasing prevalence of diabetes during pregnancy is reported, as well as substantial lack of agreement in reporting of diabetes prevalence across administrative databases. Prevalence of reported diabetes during pregnancy is impacted by screening, diagnostic, and reporting practices across different data sources, as well as by actual changes in prevalence over time.
我们研究的目的是调查1996年1月至2008年12月南卡罗来纳州人群中孕期糖尿病的患病率。
该研究纳入了387,720例非西班牙裔白人（NHW）、232,278例非西班牙裔黑人（NHB）和43,454例西班牙裔单胎活产儿。分娩时的产妇住院出院编码（91.59%）和产前信息（即医疗补助[42.91%]和南卡罗来纳州健康计划[SHP][5.98%]）与出生证明数据相关联。孕期糖尿病包括妊娠期糖尿病和孕前已患糖尿病，由产前和产妇住院的《国际疾病分类，第九修订本，临床修订版》（ICD - 9 - CM）诊断编码（即64801 - 64802、64881 - 64882或25000 - 25092）或出生证明上的报告来定义。
任何来源的糖尿病患病率从1996年的5.02%（95%置信区间[CI]：4.82 - 5.22）增至2008年的8.37%（95% CI：8.15 - 8.60）。1996年至2008年按产妇年龄和种族/族裔标准化后的糖尿病患病率，使用出生证明数据从3.38%（95% CI：3.29 - 3.47）增至5.81%（95% CI：5.71 - 5.91），使用医院出院数据从3.99%（95% CI：3.89 - 4.10）增至6.69%（95% CI：6.58 - 6.80），使用医疗补助数据从4.74%（95% CI：4.52 - 4.96）增至8.82%（95% CI：8.61 - 9.03）。将出生证明数据与医院出院数据、医疗补助数据和SHP数据进行比较，2008年的科恩kappa系数分别为0.73（95% CI：0.72 - 0.75）、0.64（95% CI：0.62 - 0.66）和0.59（95% CI：0.54 - 0.65）。
报告显示孕期糖尿病患病率呈上升趋势，且不同行政数据库在糖尿病患病率报告方面存在很大差异。孕期报告的糖尿病患病率受不同数据源的筛查、诊断和报告方式影响，也受患病率随时间的实际变化影响。
