Trends in Deliveries, Prenatal Care, and Obstetrical Complications in Women With Pregestational Diabetes: A population-based study in Ontario, Canada, 1996–2001

Epidemiology/Health Services/Psychosocial Research

Trends in Deliveries, Prenatal Care, and Obstetrical Complications in Women With Pregestational Diabetes

¹Department of Medicine, University of Toronto, Toronto, Ontario, Canada
²Division of Endocrinology, Mount Sinai Hospital, Toronto, Ontario, Canada
³Department of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
⁴Institute for Clinical and Evaluative Sciences, Toronto, Ontario, Canada

Address correspondence and reprint requests to Dr. Denice Feig, Mount Sinai Hospital, 600 University Ave., Lebovic Building, Suite 5027, Toronto, Ontario, Canada M5G 1X5. E-mail: d.feig{at}utoronto.ca

Table 1—

Characteristics of women who gave birth in Ontario hospitals, 1996–2001

Year	Total deliveries	Deliveries in Women with PGD	Age (years)
Year	Total deliveries	Deliveries in Women with PGD			Women with PGD	Women without PGD
1996	133,316	1,122 (0.8)	30.7 ± 5.5	28.9 ± 5.4
1997	131,685	1,191 (0.9)	30.7 ± 5.3	29.0 ± 5.5
1998	129,470	1,296 (1.0)	30.9 ± 5.3	29.1 ± 5.5
1999	128,679	1,352 (1.1)	31.0 ± 5.3	29.2 ± 5.5
2000	124,605	1,455 (1.2)	31.2 ± 5.5	29.3 ± 5.6
2001	128,745	1,532 (1.2)	31.2 ± 5.4	29.5 ± 5.5

Table 2—

Rates of obstetrical intervention and complications in women with and without PGD in Ontario, 1996 and 2001

Intervention	Women with PGD (rate per 100 deliveries)	Women without PGD (rate per 100 deliveries)	Adjusted OR (95% CI)*	P value for OR PGD vs. non-PGD	P value for trend†
Caesarean section
1996	6.6	18.3	2.56 (2,258–2,893)	<0.0001	<0.0001
2001	34.9	22.7	1.78 (1,597–1,979)	<0.0001
Induction
1996	31.6	21.4	1.76 (1,551–1,999)	<0.0001	0.611
2001	33.1	23.4	1.69 (1,517–1,882)	<0.0001

*
↵* ORs within each year were adjusted for age, age squared, and parity (9-year lookback).
†
↵† P value for trend is a result of modeling each outcome on PGD, age, age squared, parity, year, and year-by-PGD interaction. The P value is for the year-by-PGD interaction, to reflect the change in the effect of PGD between 1996 and 2001.

Table 3—
Percentage of women with PGD receiving specialist care or undergoing eye exams during pregnancy, 1996–2001
Specialist visit Retinal visit
1996 55 30.5
1997 54 34.0
1998 55 30.9
1999 56 29.4
2000 50 29.7
2001 50 29.3
Time trend (P value) 0.001 0.061

Data are percent.