Diabetes mellitus in pregnancy across Canada

Chantal Rm Nelson; Susie Dzakpasu; Aideen M Moore; Elizabeth K Darling; Wesley Edwards; Phil Murphy; Heather Scott; Michiel Van Den Hof; Joel G Ray

doi:10.1186/s12884-024-06534-8

Diabetes mellitus in pregnancy across Canada

BMC Pregnancy Childbirth. 2024 May 7;24(1):349. doi: 10.1186/s12884-024-06534-8.

Authors

Chantal Rm Nelson¹, Susie Dzakpasu², Aideen M Moore³, Elizabeth K Darling⁴, Wesley Edwards⁵, Phil Murphy⁶, Heather Scott⁷, Michiel Van Den Hof⁷, Joel G Ray⁸

Affiliations

¹ Maternal and Infant Health Section, Centre for Surveillance and Applied Research, Public Health Agency of Canada, 785 Carling Ave, Ottawa, ON, Canada. chantal.nelson@phac-aspc.gc.ca.
² Maternal and Infant Health Section, Centre for Surveillance and Applied Research, Public Health Agency of Canada, 785 Carling Ave, Ottawa, ON, Canada.
³ Department of Paediatrics, The Hospital for Sick Children and University of Toronto, Toronto, ON, Canada.
⁴ McMaster Midwifery Research Centre, Department of Obstetrics and Gynecology, McMaster University, Hamilton, ON, Canada.
⁵ Department of Anesthesia and Pain Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.
⁶ Newfoundland and Labrador Health Services CA, St. John's, Newfoundland and Labrador, St. John's, Canada.
⁷ Department of Obstetrics and Gynaecology, Dalhousie University, IWK Health Centre, Halifax, NS, Canada.
⁸ Departments of Medicine, Health Policy Management and Evaluation, and Obstetrics and Gynaecology, St Michael's Hospital, University of Toronto, Toronto, ON, Canada.

Abstract

Background: Contemporary estimates of diabetes mellitus (DM) rates in pregnancy are lacking in Canada. Accordingly, this study examined trends in the rates of type 1 (T1DM), type 2 (T2DM) and gestational (GDM) DM in Canada over a 15-year period, and selected adverse pregnancy outcomes.

Methods: This study used repeated cross-sectional data from the Canadian Institute of Health Information (CIHI) hospitalization discharge abstract database (DAD). Maternal delivery records were linked to their respective birth records from 2006 to 2019. The prevalence of T1DM, T2DM and GDM were calculated, including relative changes over time, assessed by a Cochrane-Armitage test. Also assessed were differences between provinces and territories in the prevalence of DM.

Results: Over the 15-year study period, comprising 4,320,778 hospital deliveries in Canada, there was a statistically significant increase in the prevalence of GDM and T1DM and T2DM. Compared to pregnancies without DM, all pregnancies with any form of DM had higher rates of hypertension and Caesarian delivery, and also adverse infant outcomes, including major congenital anomalies, preterm birth and large-for-gestational age birthweight.

Conclusion: Among 4.3 million pregnancies in Canada, there has been a rise in the prevalence of DM. T2DM and GDM are expected to increase further as more overweight women conceive in Canada.

Keywords: Canada; Gestational diabetes, pregnancy, trend; Pre-existing diabetes; Type 2 diabetes.

MeSH terms

Adult
Canada / epidemiology
Cesarean Section / statistics & numerical data
Cross-Sectional Studies
Diabetes Mellitus, Type 1* / epidemiology
Diabetes Mellitus, Type 2* / epidemiology
Diabetes, Gestational* / epidemiology
Female
Humans
Infant, Newborn
Pregnancy
Pregnancy Outcome* / epidemiology
Pregnancy in Diabetics* / epidemiology
Premature Birth / epidemiology
Prevalence
Young Adult