{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T21:03:45Z","timestamp":1791925425554,"version":"4.3.4"},"reference-count":38,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2020,2,21]],"date-time":"2020-02-21T00:00:00Z","timestamp":1582243200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"the FIS (Fondo de Investigaciones Sanitarias\u2014Health Research Fund, Instituto de Salud Carlos III) and co-financed by the European Union through the Fondo Europeo de Desarrollo Regional (FEDER, \u201cUna manera de hacer Europa\u201d)","award":["PI16\/00564"],"award-info":[{"award-number":["PI16\/00564"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>(1) Background: We examined trends in incidence and outcomes in women with existing type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM) and gestational diabetes mellitus (GDM) compared with a control group without diabetes. (2) Methods: This was an observational, retrospective epidemiological study using the National Hospital Discharge Database. (3) Results: There were 2,481,479 deliveries in Spain between 2009 and 2015 (5561 mothers with T1DM, 4391 with T2DM, and 130,980 with GDM). Incidence and maternal age of existing diabetes and GDM increased over time. Women with T2DM were more likely to have obstetric comorbidity (70.12%) than those with GDM (60.28%), T1DM (59.45%), and no diabetes (41.82%). Previous cesarean delivery, preeclampsia, smoking, hypertension, and obesity were the most prevalent risk factors in all types of diabetes. Women with T1DM had the highest rate of cesarean delivery (Risk Ratio (RR) 2.34; 95% Confidence Interval (CI) 2.26\u20132.43) and prolonged maternal length of stay. Labor induction was higher in T2DM (RR 1.99; 95% CI 1.89\u20132.10). Women with T1DM had more severe maternal morbidity (RR 1.97; 95% CI 1.70\u20132.29) and neonatal morbidity (preterm birth, RR 3.32; 95% CI 3.14\u20133.51, and fetal overgrowth, RR 8.05; 95% CI 7.41\u20138.75). (4) Conclusions: existing and GDM incidence has increased over time. We found differences in the prevalence of comorbidities, obstetric risk factors, and the rate of adverse obstetric outcomes among women with different types of diabetes. Pregnant women with diabetes have the highest risk of adverse pregnancy outcomes.<\/jats:p>","DOI":"10.3390\/jcm9020582","type":"journal-article","created":{"date-parts":[[2020,2,25]],"date-time":"2020-02-25T08:12:22Z","timestamp":1582618342000},"page":"582","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":45,"title":["A Population-Based Study of Diabetes during Pregnancy in Spain (2009\u20132015): Trends in Incidence, Obstetric Interventions, and Pregnancy Outcomes"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5551-5181","authenticated-orcid":false,"given":"Ana","family":"L\u00f3pez-de-Andr\u00e9s","sequence":"first","affiliation":[{"name":"Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorc\u00f3n, 28922 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Napole\u00f3n","family":"Perez-Farinos","sequence":"additional","affiliation":[{"name":"Public Health and Psychiatry Department, Faculty of Medicine, Universidad de Malaga, 29071 Malaga, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5790-1959","authenticated-orcid":false,"given":"Valent\u00edn","family":"Hern\u00e1ndez-Barrera","sequence":"additional","affiliation":[{"name":"Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorc\u00f3n, 28922 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda A.","family":"Palomar-Gallego","sequence":"additional","affiliation":[{"name":"Basic Science Department, Health Sciences Faculty, Rey Juan Carlos University, Alcorc\u00f3n, 28922 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9897-4847","authenticated-orcid":false,"given":"David","family":"Carabantes-Alarc\u00f3n","sequence":"additional","affiliation":[{"name":"Department of Public Health &amp; Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 J.","family":"Zamorano-Le\u00f3n","sequence":"additional","affiliation":[{"name":"Department of Public Health &amp; Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4543-573X","authenticated-orcid":false,"given":"Javier","family":"De Miguel-Diez","sequence":"additional","affiliation":[{"name":"Respiratory Department, Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigaci\u00f3n Sanitaria Gregorio Mara\u00f1\u00f3n (IiSGM), 28009 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6119-4222","authenticated-orcid":false,"given":"Rodrigo","family":"Jimenez-Garcia","sequence":"additional","affiliation":[{"name":"Department of Public Health &amp; Maternal and Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,2,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1038\/s41372-019-0516-5","article-title":"The association of pregestational and gestational diabetes with severe neonatal morbidity and mortality","volume":"40","author":"Battarbee","year":"2019","journal-title":"J. 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