GSB 7.1 Standardlösung

Prevalence of gestational diabetes

Gestational diabetes is a blood sugar disorder first diagnosed during pregnancy. In most women it disappears after birth, but increases the risk of pregnancy complications for mother and child (Metzger et al. 2008) and the mother's risk of developing type 2 diabetes at a later stage (Rayanagoudar et al. 2016).

Key messages

  • More than 54,000 pregnant women were affected by gestational diabetes in 2019.
  • Data from quality assurance in inpatient obstetrics demonstrate an increase in gestational diabetes among women who have given birth in hospital since 2013.
  • Continuous analyses of screening, documentation and changes in maternal risk factors are necessary for a reliable assessment of the increase in gestational diabetes prevalence.

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By state

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  • By gender

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  • By age

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  • By education group

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Results

In 2018, gestational diabetes was identified among 51,318 of the 752,773 (6.8%) women who gave birth in hospital in Germany. The figures demonstrate a steady increase from 4.6% in 2013 to 6.8% in 2018. Furthermore, the prevalence of gestational diabetes increases significantly with increasing maternal age at birth: in 2018, while 2.5% of women under 20 were affected by gestational diabetes, for women aged 45 or over it was 15.9%.

Conclusion

There has been an increase in the prevalence of gestational diabetes, which may be influenced by various factors. On the one hand, the average age at birth and the frequency of obesity, which are risk factors for gestational diabetes, have increased among mothers (IQTIG 2018, Destatis 2019). On the other hand, the guideline for gestational diabetes was changed in 2012 and screening was introduced as a statutory health insurance benefit, which may have led to an increase in diagnosis and documentation. Studies from other data sources provide higher estimates of gestational diabetes (Melchior et al. 2017, Tamayo et al. 2016). This highlights the need for studies to improve data quality, for example to check for possible documentation gaps.

Show more information on methodology and data sources

Definition

The indicator Prevalence of gestational diabetes is defined as the proportion of women giving birth in hospital (including stillbirths) in a given year with a diagnosis of gestational diabetes documented in their maternity log or an ICD-10 diagnosis O24.4 documented during their hospital stay.

Reference population

All women who gave birth in hospital in Germany after exclusion of women with pre-existing diabetes mellitus (approximately 1 % of all women).

Data source

Quality assurance perinatal medicine (obstetrics) at the Institute for Quality and Transparency in Health Care (IQTIG) since 2015 based on the perinatal statistics provided by the federal states. This source provides data on all of the approximately 700,000 births that occur in German hospitals annually.

Calculation

  • Observed relative values: The quotient of the number of women who gave birth in hospital with gestational diabetes recorded in their maternity log in relation to all women who gave birth in hospital after exclusion of women with pre-existing diabetes. The stratification by federal state reflects the location of the hospital in which the birth took place.
  • Observed absolute Value: Number of women, who gave birth in hospital, with gestational diabetes recorded in their maternity log or a documented ICD-10 diagnosis O24.4 during their hospitalization.
  • Age standardisation: Direct age standardisation under 20-year-olds as one age group, five-year age groups for the ages 20 to 24 until 40 to 44, and then a separate group for the ages 45 and over. The population of women giving birth in hospital in 2018 was used as the reference population.

Data quality

As the data set is provided by hospitals, it only contains information on births that occurred in a hospital setting, as the data is entered by the hospitals. Therefore, the dara of births that take place outside of hospitals, which are less than 2 % of all birth, are not included. As documentation of gestational diabetes in maternity logs might be incomplete, it is possible that prevalence is being underestimated.

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