Increased Maternal Age and Primiparity of Women with Gestational Diabetes: Implications for Treatment and Workload — ASN Events
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  3. Increased Maternal Age and Primiparity of Women with Gestational Diabetes: Implications for Treatment and Workload

Increased Maternal Age and Primiparity of Women with Gestational Diabetes: Implications for Treatment and Workload (#311)

Arianne Sweeting 1 , Maria Constantino 1 , Lynda Molyneaux 2 , Dennis Yue 1 2 , Glynis Ross 1
  1. Royal Prince Alfred Hospital, Diabetes Centre, Sydney, Australia
  2. Discipline of Medicine, University of Sydney, Sydney, Australia

Background: Higher maternal age and the multi-ethnic population in Australia contribute to the increasing prevalence of Gestational Diabetes (GDM)1. We examined how these trends may have affected patient demographics and management at our GDM Clinic.
Methods: The demographic and clinical profiles of 4792 women in our GDM clinic database collected over two decades were analysed according to maternal age, ethnicity and parity. The rates of caesarean section, hypertension and requirement for insulin treatment were examined by multivariate analysis with maternal age as an independent variable.
Results: Overall there was no significant trend of increasing age in women with GDM over twenty years. However, in the three major ethnic groups accounting for 75% of patient population, the age of primiparous Anglo-Celtic (2.1 years) and European (2.3 years) subjects significantly increased but significantly decreased in their Asian counterparts (1.3 years). By contrast, age of multiparous women increased in all three ethnic groups (2.3, 2.0 and 0.4 years respectively). Primiparous women over this period increased from 27.4 to 51.8% and mean parity decreased in all women from 1.6 to 0.7. Primiparity was associated with 47% increase in hypertension, 17.5% increase in caesarean section and 14% increase in insulin treatment. Maternal age was a significant determinant of caesarean section (+10.2%/Δyr, p<0.0001), hypertension (+5.4%/Δyr, p<0.0001) and requirement of insulin treatment (+35.6%/Δyr, p<0.03).
Conclusions: There is increasing age of women in our GDM clinic, except for primiparous Asian women, which may reflect sociological changes of this migrant group. Socioeconomic factors have likely changed the patient mix of our GDM clinic towards primiparity. The greater representation of older primiparous women is associated with more caesarean section, hypertension and insulin treatment. The increased workload of a modern day GDM clinic is not merely due to increased patient numbers but also to increased complexity of their pregnancies.

493-ADS%208.8

  1. The Australian Institute of Health and Welfare 2010. Diabetes in pregnancy: its impact on Australian women and their babies. Diabetes series no. 14. Cat. no. CVD 52. Canberra: AIHW.