(259) Evaluating the Incidence and Burden of Gestational Diabetes in the United States: A Retrospective Study (2015-2022)

Background: Gestational diabetes mellitus (GDM) refers to a condition in pregnant women characterized by impaired glucose tolerance that onsets or is first recognized during pregnancy. In recent years, GDM has emerged as a growing public health concern, primarily due to its negative impact on maternal and child health.

Objectives: This study leverages a nationally representative real-world database of 2,469,440 pregnancies to assess the incidence and burden of gestational diabetes mellitus among women aged 20 to 49 years in the United States from 2015 to 2022. By examining different subgroups of race, body mass index (BMI), and age, we aim to identify key trends and disparities in the occurrence of GDM, contributing to the development of enhanced public health strategies and healthcare interventions.

Methods: Utilizing the IQVIA™ US Ambulatory EMR dataset, formatted in the Observational Medical Outcomes Partnership (OMOP) common data model, a retrospective analysis of GDM cases was conducted between 1st January 2015 and 31st December 2022. Incidence rates were calculated as the number of new GDM cases per 1,000 person-years (PY) of the total women at risk of getting exposed for each calendar year.

Results: Results showed that the overall incidence rates of GDM increased from 2.17 to 2.59 per 1,000 PY from 2015 to 2022. Notable disparities were observed across different subgroups. Women with obesity experienced higher incidence rates (1.65 per 1,000 PY) compared to those with overweight (0.77 per 1,000 PY) or normal BMI (0.29 per 1,000 PY) in 2022. Higher incidence rates were observed among white women (1.46 per 1,000 PY in 2022) compared to Asian and African American women (0.41 per 1,000 PY in 2022), although 22,611 (27%) women in the study cohort did not have a record of race (0.71 per 1,000 PY in 2022). However, the change in incidence rates from 2015 to 2022 increased the most in Asian and African women (41.4%), followed by women without a race recorded (39.2%), and lastly in white women (5.8%). Age-related trends also revealed a higher incidence in the 30-39 age group (19% increase from 3.70 per 1,000 PY in 2015) compared to the 20-29 age group (46% increase from 1.89 per 1,000 PY in 2015), although the incidence was lowest in the 40-49 age group (with a 16% decrease from 1.05 per 1,000 PY in 2015 to 2022).

Conclusions: The rising trend of GDM incidence in the United States, along with significant disparities across racial/ethnic groups, BMI, and age, underscores the need for targeted public health interventions and tailored healthcare services. This study highlights critical areas for future research and policy development, aiming to reduce the burden of GDM and improve maternal and neonatal outcomes.