GSB 7.1 Standardlösung

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Diabetes in Germany - adults

Premature birth

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Both diabetes occurring for the first time during pregnancy (prevalence of gestational diabetes) and diabetes existing before pregnancy (pregestational diabetes) present a risk for complications during pregnancy and birth (DDG et al. 2021; DDG 2018). Thus, diabetes increases the risk of premature birth, which can subsequently affect the health of the newborn and later child development.

Key messages

  • In 2021, the proportion of premature singletons was 6.1%.
  • In the presence of gestational diabetes (6.5%) or pregestational diabetes (14.3%), the proportion of preterm births was higher than in women without diabetes (5.9%).
  • Over time, the proportion of premature births in women with pregestational diabetes increases from 12.6% in 2013 to 14.3% in 2021, while this decreases slightly in women without diabetes or with gestational diabetes.

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trend

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cross-section

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 2021, 6.1% of all singletons were born before the completed 37th week of gestation. The proportion of premature births was higher in women with gestational diabetes (6.5%) and pregestational diabetes (14.3%) than in women without diabetes (5.9%). Over time from 2013 to 2021, the proportion of premature births decreased in women without diabetes (2013: 6.8%; 2021: 5.9%) and women with gestational diabetes (2013: 7.4%; 2021: 6.5%) and increased in women with pregestational diabetes (2013: 12.6%; 2021: 14.3%). Differentiated by age group, a higher proportion of preterm births is seen in women aged 40 years and older and in women under 25 years of age compared to women in the middle age groups, with these differences being particularly pronounced in the presence of pregestational diabetes.

Conclusion

While there is a decrease in premature births over time for women without diabetes or with gestational diabetes, the proportion of premature births increases for women with pregestational diabetes. According to the National Health Goal “Gesundheit rund um die Geburt” (Health around Childbirth) the proportion of premature births should be reduced (BMG, 2017). However, the analysis shows that women with pregestational diabetes are not equally reached, even considering the increase in maternal age. The relatively high proportion of premature births in women with pregestational diabetes under 25 years of age, suggests that particular emphasis should be on the care of pregnant women with type 1 diabetes.

Show more information on methodology and data sources

Definition

The indicator premature birth is defined as the proportion of women with hospital births in a given year in which the child was born before the completed 37th week of pregnancy.

Reference population

All women with inpatient singleton births in Germany.

Data sources

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: Quotient of the number of women with birth before the completed 37th week of pregnancy and the number of all women with hospital birth.
  • Age standardisation: Direct age standardization is performed using age groups <25, 25-29, 30-34, 35-39, and ≥40 years with the 2021 hospital birth population.
  • Stratification: The analysis distinguishes between women with pregestational diabetes (documented in Catalog A: "Medical History and General Findings/First Screening Examination" in the maternity log), gestational diabetes (prevalence of gestational diabetes), and no diabetes.

Data quality

The data only contains information on in-hospital birth, as the data is provided by the hospitals. Therefore, data from out-of-hospital births, which represent a very small proportion of less than 2%, are not included. As documentation of gestational diabetes in maternity logs might be incomplete, it is possible that prevalence is being underestimated. Furthermore, no distinction between type 1 and type 2 diabetes is possible in pregestational diabetes.

Referencen and external links

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