ArticleDiabetes care2026
Trends in Pregestational Diabetes and Gestational Diabetes Mellitus and Associations With Severe Maternal Morbidity in U.S. Delivery Hospitalizations, 2016-2022.
Article in Diabetes care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo describe trends in the prevalence of gestational diabetes mellitus (GDM), pregestational diabetes (type 1 and type 2), and severe maternal morbidity (SMM) in the U.S., and to examine associations between diabetes status and type with SMM. RESEARCH DESIGN AND
methodsThis retrospective study used 2016-2022 data from the Healthcare Cost and Utilization Project National Inpatient Sample. Delivery hospitalizations among women ages 12-55 years were identified. Modified Poisson regression models were used to estimate relative risks (RRs) for overall and nontransfusion SMM, adjusting for sociodemographic and clinical characteristics.
resultsAmong 25,138,817 delivery hospitalizations, the prevalence of GDM increased from 7.1 to 9.5 per 100 deliveries, pregestational type 2 diabetes increased from 0.8 to 1.1 per 100 deliveries, and pregestational type 1 diabetes remained stable at 0.3 per 100 deliveries from 2016 to 2022. Overall SMM increased from 160.0 to 220.3 per 10,000 deliveries; nontransfusion SMM increased from 72.0 to 93.0 per 10,000 deliveries. In sociodemographic-adjusted models, compared with women without diabetes, type 1 diabetes was associated with the highest risk of nontransfusion SMM (RR 4.94; 95% CI 4.55-5.35), followed by type 2 diabetes (RR 2.58; 95% CI 2.43-2.74) and GDM (RR 1.12; 95% CI 1.08-1.15).
conclusionsFrom 2016 to 2022, GDM and pregestational type 2 diabetes rose in parallel with increasing SMM. While GDM was the most prevalent, pregestational diabetes, particularly type 1, was associated with a higher risk of SMM. The increased risk for SMM associated with all forms of diabetes in pregnancy highlights the importance of cardiometabolic risk management and the need for comprehensive, multidisciplinary care during pregnancy and delivery.
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