Rate of pregnant US women who have diabetes keeps rising

The number of American women who have diabetes when they become pregnant has increased dramatically over five years, health officials reported Wednesday.

Between 2016 and 2021, the rate of pregnancy among diabetic women has risen 27%, from about 9 per 1,000 births to 11 per 1,000 births, according to the report from the U.S. Centers for Disease Control and Prevention.

Primary reasons for this increase are most likely the ongoing obesity epidemic and the fact that more older women are having children.

"The findings are consistent with the increased risk of type 2 diabetes among people who are overweight or obese," said lead researcher Elizabeth Gregory, a health scientist at CDC's National Center for Health Statistics (NCHS).

"And when we looked at other studies, there was an increasing rate of pre-pregnancy diabetes with advancing maternal age," Gregory said.

One expert said these trends do indeed appear to be driving the increase in pre-pregnancy diabetes cases.

"The study illustrates that the same trends noted in the U.S. in prior years are ongoing, with diabetes being a major public concern," said Dr. Eran Bornstein, director of obstetrics and gynecology at Lenox Hill Hospital in New York City.

"Despite knowledge of these data and associated risk factors, public health interventions to date have not been sufficient in halting this concerning trend," Bornstein said. "These data call for increased public health efforts to target interventions such as education on nutrition and physical activity, as well as facilitation of healthy lifestyle with specific targeting of the populations that are at risk."

In 2021, the rate of diabetic women getting pregnant varied from a low of 9 per 1,000 births among white women to a high of nearly 29 per 1,000 births among American Indian or Alaska Native women, the study found.

The rate also rose among women aged 40 and older and obese women, the researchers reported.

And it varied by state, from less than 9 per 1,000 births in Hawaii, Wyoming, Utah and Colorado to a high of 15 per 1,000 births or more in Tennessee, Vermont and New Mexico.

For the study, the investigators used data on U.S. birth certificates from 2016 to 2021. The findings were published May 31 as an NCHS data brief, the National Vital Statistics Reports.

"These findings are worrisome, as being diabetic before pregnancy can cause complications for both mother and baby," said Dr. Sarah Pachtman, a maternal/fetal physician at Katz Women's Hospital of LIJ Medical Center in New Hyde Park, N.Y.

"This is concerning because we know that a diagnosis of diabetes before pregnancy puts pregnancies at increased risk including a higher chance of preeclampsia, fetal growth restriction and stillbirth on one spectrum, and large-for-gestational-age neonates [newborns] and polyhydramnios [excess of amniotic fluid] on the other spectrum," she said.

Moreover, poorly controlled diabetes before pregnancy is a risk factor for birth defects, especially of the heart, brain and spinal cord, Pachtman added.

"Pre-pregnancy diabetes is one of the most important diagnoses to get under control before getting pregnant to ensure the healthiest possible pregnancy," she said.

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