Gestational diabetes mellitus: prevalence, risk factors, maternal and infant outcomes

Objectives: To study prevalence, risk factors, and maternal and infant outcomes of women with gestational diabetes mellitus (GDM). Methods: A retrospective cohort study was performed based on 111563 pregnancies delivered between 1991 through 1997 in 39 hospitals in northern and central Alberta, Canada. Multivariate logistic regression was used to estimate the odds ratios with 95% confidence intervals, and to control for confounding variables. Results. The prevalence of GDM was 2.5%. Risk factors for GDM included age >35 years, obesity, history of prior neonatal death, and prior cesarean section. Teenage mothers and women who drank alcohol were less likely to have GDM. Mothers with GDM were at increased risk of presenting with pre-eclampsia, premature rupture of membranes, cesarean section, and preterm delivery. Infants born to mothers with GDM were at higher risk of being macrosomic or large-for-ge station al-age. Conclusions: Specific conditions predispose to GDM which itself is associated with a significantly increased risk of maternal and fetal morbidity. (C) 2001 Elsevier Science B.V. International Federation of Gynecology and Obstetrics.