Abstract

Objective: To examine trends in the prevalence of diabetes among delivery hospitalizations in the United States and to describe the characteristics of these hospitalizations.

Research Design and Methods: Hospital discharge data from 1994 through 2004 were obtained from the Nationwide Inpatient Sample (NIS). Diagnosis codes were selected for gestational diabetes mellitus (GDM), Type 1, Type 2, and unspecified diabetes. Rates of delivery hospitalization with diabetes were calculated per 100 deliveries.

Results: Overall, an estimated 1,863,746 hospital delivery discharges contained a diabetes diagnosis, corresponding to a rate of 4.3/100 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 and Type 2 diabetes significantly increased overall and within each age group (15-24, 25-34, >=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 >=35 years vs. 15-24 years (OR=4.80, 95% CI 4.72-4.89), urban vs. rural location (OR=1.14, 95% CI 1.11-1.17), and Medicaid/Medicare vs. other payment sources (OR=1.29, 95% CI 1.26-1.32).

Conclusions: 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.