Gestational diabetes in Victoria in 1996: incidence, risk factors and outcomes

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Abstract
Objectives: To describe the epidemiology of gestational diabetes mellitus (GDM) in Victoria. Study design: Population study of all women having singleton births in Victoria in 1996. Methods: Probabilistic record linkage of routinely collected data and capture–recapture techniques to provide an estimate of the incidence of GDM. Main outcome measures: Risk factors for and the adverse outcomes associated with GDM compared with the non‐diabetic population by univariate and multivariate analysis. Results: The estimated incidence of GDM was 3.6% (95% confidence interval [CI], 3.60%–3.64%). GDM is associated with women who are older, Aboriginal, non‐Australian born, or who give birth in a larger hospital. The adverse outcomes associated with GDM pregnancies were hypertension/pre‐eclampsia (adjusted odds ratio [OR], 1.6; 95% CI, 1.4–1.9), hyaline membrane disease (1.6; 1.2–2.2), neonatal jaundice (1.4; 1.2–1.7) and macrosomia (2.0; 1.8–2.3). Interventions during childbirth were also associated with GDM — for example, induction of labour (3.0; 2.7–3.4) and caesarean section (1.7; 1.6–1.9). Conclusion: Women with GDM had increased rates of hypertension, pre‐eclampsia, induced labour, and interventional delivery. Their offspring had a higher risk of macrosomia, neonatal jaundice and hyaline membrane disease.