Trends in Hospitalizations and Emergency Department Visits Among Women with Hyperglycemia in Pregnancy Between 2008 and 2017 in Taiwan

Overview

Journal Front Endocrinol (Lausanne)

Specialty Endocrinology

Date 2022 Dec 12

PMID 36506052

Authors

Jun-Sing Wang

Ming-Chu Chin

Jung-Fu Chen

Chien-Ning Huang

Chii-Min Hwu

Horng-Yih Ou

Yi-Sun Yang

Chih-Cheng Hsu

Chih-Yuan Wang

Affiliations

Soon will be listed here.

Abstract

Introduction: We investigated health service utilization, including hospitalizations and emergency department visits, for women with hyperglycemia in pregnancy between 2008 and 2017 in Taiwan.

Methods: Data from the Health and Welfare Data Science Center were used to conduct this nationwide population-based study. We identified pregnant women and the date of childbirth according to Birth Certificate Applications from 2007 to 2018. The study population was divided into four groups: known DM, newly diagnosed DM, GDM, and no DM/GDM. To assess quality of healthcare during the gestation period, trends in 30-day readmission rate, number of emergency department visits/hospitalizations per 100 childbirths, and length of hospital stay from 2008 to 2017 were examined.

Results: A total of 1830511 childbirths and 990569 hospitalizations were identified for analyses. Between 2008 and 2017, women with hyperglycemia in pregnancy (known DM, newly diagnosed DM, and GDM) had a higher rate of hospitalization, a longer length of hospital stay, and higher rates of various maternal and fetal outcomes, compared with women with no DM/GDM. Nevertheless, the differences between women with GDM and those with no DM/GDM in the aforementioned outcome measures were modest. Women with GDM had a modest decrease in the 30-day readmission rate (p for trend 0.046) with no significant difference in the number of emergency department visits during the study period.

Discussion: Our findings provide evidence of the quality of healthcare for women with GDM between 2008 and 2017 in Taiwan.

Citing Articles

Risks after Gestational Diabetes Mellitus in Taiwanese Women: A Nationwide Retrospective Cohort Study.

Tseng S, Lee M, Tsai Y, Lu M, Yu S, Tsai I Biomedicines. 2023; 11(8).

PMID: 37626617 PMC: 10452882. DOI: 10.3390/biomedicines11082120.

References

Crowther C, Hiller J, Moss J, McPhee A, Jeffries W, Robinson J . Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. N Engl J Med. 2005; 352(24):2477-86. DOI: 10.1056/NEJMoa042973. View

Macintosh M, Fleming K, Bailey J, Doyle P, Modder J, Acolet D . Perinatal mortality and congenital anomalies in babies of women with type 1 or type 2 diabetes in England, Wales, and Northern Ireland: population based study. BMJ. 2006; 333(7560):177. PMC: 1513435. DOI: 10.1136/bmj.38856.692986.AE. View

Metzger B, Buchanan T, Coustan D, DE Leiva A, Dunger D, Hadden D . Summary and recommendations of the Fifth International Workshop-Conference on Gestational Diabetes Mellitus. Diabetes Care. 2008; 30 Suppl 2:S251-60. DOI: 10.2337/dc07-s225. View

. Screening for gestational diabetes mellitus: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2008; 148(10):759-65. DOI: 10.7326/0003-4819-148-10-200805200-00008. View

Farrar D, Fairley L, Santorelli G, Tuffnell D, Sheldon T, Wright J . Association between hyperglycaemia and adverse perinatal outcomes in south Asian and white British women: analysis of data from the Born in Bradford cohort. Lancet Diabetes Endocrinol. 2015; 3(10):795-804. PMC: 4673084. DOI: 10.1016/S2213-8587(15)00255-7. View

Fox H, Callander E . Health service use and health system costs associated with diabetes during pregnancy in Australia. Nutr Metab Cardiovasc Dis. 2021; 31(5):1427-1433. DOI: 10.1016/j.numecd.2021.02.009. View

Venkatesh K, Lynch C, Powe C, Costantine M, Thung S, Gabbe S . Risk of Adverse Pregnancy Outcomes Among Pregnant Individuals With Gestational Diabetes by Race and Ethnicity in the United States, 2014-2020. JAMA. 2022; 327(14):1356-1367. PMC: 9006108. DOI: 10.1001/jama.2022.3189. View

Tennant P, Glinianaia S, Bilous R, Rankin J, Bell R . Pre-existing diabetes, maternal glycated haemoglobin, and the risks of fetal and infant death: a population-based study. Diabetologia. 2013; 57(2):285-94. DOI: 10.1007/s00125-013-3108-5. View

Feldman R, Tieu R, Yasumura L . Gestational Diabetes Screening: The International Association of the Diabetes and Pregnancy Study Groups Compared With Carpenter-Coustan Screening. Obstet Gynecol. 2015; 127(1):10-17. DOI: 10.1097/AOG.0000000000001132. View

10.

Landon M, Spong C, Thom E, Carpenter M, Ramin S, Casey B . A multicenter, randomized trial of treatment for mild gestational diabetes. N Engl J Med. 2009; 361(14):1339-48. PMC: 2804874. DOI: 10.1056/NEJMoa0902430. View

11.

Moyer V . Screening for gestational diabetes mellitus: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2014; 160(6):414-20. DOI: 10.7326/M13-2905. View

12.

Metzger B, Lowe L, Dyer A, Trimble E, Chaovarindr U, Coustan D . Hyperglycemia and adverse pregnancy outcomes. N Engl J Med. 2008; 358(19):1991-2002. DOI: 10.1056/NEJMoa0707943. View

13.

Carpenter M, Coustan D . Criteria for screening tests for gestational diabetes. Am J Obstet Gynecol. 1982; 144(7):768-73. DOI: 10.1016/0002-9378(82)90349-0. View

14.

Tennant P, Bilous R, Prathapan S, Bell R . Risk and recurrence of serious adverse outcomes in the first and second pregnancies of women with preexisting diabetes. Diabetes Care. 2015; 38(4):610-9. DOI: 10.2337/dc14-1888. View

15.

Meek C, Lewis H, Patient C, Murphy H, Simmons D . Diagnosis of gestational diabetes mellitus: falling through the net. Diabetologia. 2015; 58(9):2003-12. PMC: 4526580. DOI: 10.1007/s00125-015-3647-z. View

16.

Billionnet C, Mitanchez D, Weill A, Nizard J, Alla F, Hartemann A . Gestational diabetes and adverse perinatal outcomes from 716,152 births in France in 2012. Diabetologia. 2017; 60(4):636-644. PMC: 6518373. DOI: 10.1007/s00125-017-4206-6. View

17.

Hedderson M, Ehrlich S, Sridhar S, Darbinian J, Moore S, Ferrara A . Racial/ethnic disparities in the prevalence of gestational diabetes mellitus by BMI. Diabetes Care. 2012; 35(7):1492-8. PMC: 3379591. DOI: 10.2337/dc11-2267. View

18.

Bell R, Glinianaia S, Tennant P, Bilous R, Rankin J . Peri-conception hyperglycaemia and nephropathy are associated with risk of congenital anomaly in women with pre-existing diabetes: a population-based cohort study. Diabetologia. 2012; . DOI: 10.1007/s00125-012-2455-y. View

19.

Whiteman V, Salemi J, Mejia de Grubb M, Cain M, Mogos M, Zoorob R . Additive effects of Pre-pregnancy body mass index and gestational diabetes on health outcomes and costs. Obesity (Silver Spring). 2015; 23(11):2299-308. DOI: 10.1002/oby.21222. View

20.

Tsakiridis I, Giouleka S, Mamopoulos A, Kourtis A, Athanasiadis A, Filopoulou D . Diagnosis and Management of Gestational Diabetes Mellitus: An Overview of National and International Guidelines. Obstet Gynecol Surv. 2021; 76(6):367-381. DOI: 10.1097/OGX.0000000000000899. View