School of Nursing and Midwifery, Griffith University, Gold Coast, Queensland, Australia.
School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Nutr Metab Cardiovasc Dis. 2021 May 6;31(5):1427-1433. doi: 10.1016/j.numecd.2021.02.009. Epub 2021 Feb 17.
In the context of the rising rate of diabetes in pregnancy in Australia, this study aims to examine the health service and resource use associated with diabetes during pregnancy.
This project utilised a linked administrative dataset containing health and cost data for all mothers who gave birth in Queensland, Australia between 2012 and 2015 (n = 186,789, plus their babies, n = 189,909). The association between maternal characteristics and diabetes status were compared with chi-square analyses. Multiple logistic regression produced the odds ratio of having different outcomes for women who had diabetes compared to women who did not. A two-sample t-test compared the mean number of health services accessed. Generalised linear regression produced the mean costs associated with health service use. Mothers who had diabetes during pregnancy were more likely to have their labour induced at <38 weeks gestation (OR:1.39, 95% CI:1.29-1.50); have a cesarean section (OR: 1.26, 95% CI:1.22-1.31); have a preterm birth (OR:1.24, 95%: 1.18-1.32); have their baby admitted to a Special Care Nursery (OR: 2.34, 95% CI:2.26-2.43) and a Neonatal Intensive Care Unit (OR:1.25, 95%CI: 1.14-1.37). On average, mothers with diabetes access health services on more occasions during pregnancy (54.4) compared to mothers without (50.5). Total government expenditure on mothers with diabetes over the first 1000 days of the perinatal journey was significantly higher than in mothers without diabetes ($12,757 and $11,332).
Overall, mothers that have diabetes in pregnancy require greater health care and resource use than mothers without diabetes in pregnancy.
在澳大利亚妊娠糖尿病发病率上升的背景下，本研究旨在探讨妊娠期间糖尿病相关的医疗服务和资源利用情况。
本项目利用了一个包含澳大利亚昆士兰州 2012 年至 2015 年所有产妇及其婴儿健康和成本数据的关联行政数据集（n=186789 例产妇，n=189909 例婴儿）。采用卡方分析比较了产妇特征与糖尿病状态之间的关联。多因素逻辑回归分析得出了患有糖尿病的产妇与未患糖尿病的产妇在不同结局方面的比值比。采用两样本 t 检验比较了两组产妇接受的医疗服务数量。采用广义线性回归分析得出了与医疗服务使用相关的平均费用。患有妊娠糖尿病的产妇更有可能在 38 周前进行引产（OR：1.39，95%CI：1.29-1.50）；剖宫产（OR：1.26，95%CI：1.22-1.31）；早产（OR：1.24，95%：1.18-1.32）；其婴儿入住特殊护理病房（OR：2.34，95%CI：2.26-2.43）和新生儿重症监护病房（OR：1.25，95%CI：1.14-1.37）。平均而言，患有糖尿病的产妇在妊娠期间接受医疗服务的次数多于未患糖尿病的产妇（54.4 次比 50.5 次）。在妊娠期间，患有糖尿病的产妇在妊娠前 1000 天的政府总支出显著高于未患糖尿病的产妇（12757 美元和 11332 美元）。
总体而言，患有妊娠糖尿病的产妇比未患糖尿病的产妇需要更多的医疗保健和资源利用。
