Association of types of diabetes and insulin dependency on birth outcomes

Table 1 Distribution of demographic factors and birth outcomes by diabetes status (n = 203222)

	Overall		Non-diabetic		PD-I		PD-NI		GD-I		GD-NI		Chi-Square	Cramer's V
	n	%	n	%	n	%	n	%	n	%	n	%
	204057	100.00%	192329	94.40%	733	0.40%	798	0.40%	742	0.40%	9455	4.60%
Age													< 0.0001	0.06
≤ 19	19374	9.50%	18915	9.80%	31	4.20%	25	3.10%	20	2.70%	383	4.10%
20-34	163515	80.10%	154633	80.40%	553	75.40%	598	74.90%	563	75.90%	7168	75.80%
≥ 35	21168	10.40%	18781	9.80%	149	20.30%	175	21.90%	159	21.40%	1904	20.10%
Race													< 0.0001	0.02
White Non-Hispanic	157144	77.00%	148434	77.20%	532	72.60%	539	67.50%	492	66.30%	7147	75.60%
Black Non-Hispanic	30053	14.70%	28420	14.80%	139	19.00%	182	22.80%	161	21.70%	1151	12.20%
Hispanic	10638	5.20%	9813	5.10%	41	5.60%	50	6.30%	60	8.10%	674	7.10%
Other Non-Hispanic	6222	3.00%	5662	2.90%	21	2.90%	27	3.40%	29	3.90%	483	5.10%
Education													< 0.0001	0.02
Less than HS	32650	16.00%	30970	16.10%	134	18.30%	118	14.80%	106	14.30%	1322	14.00%
HS or GED	49222	24.10%	46356	24.10%	188	25.60%	216	27.10%	203	27.40%	2259	23.90%
Some college	64878	31.80%	60666	31.50%	282	38.50%	274	34.30%	298	40.20%	3358	35.50%
College grad or more	57307	28.10%	54337	28.30%	129	17.60%	190	23.80%	135	18.20%	2516	26.60%
Married/paternity													< 0.0001	0.02
Married paternity acknowledged	121764	59.70%	114191	59.40%	430	58.70%	490	61.40%	444	59.80%	6209	65.70%
Not married paternity acknowledged	54920	26.90%	52032	27.10%	191	26.10%	202	25.30%	184	24.80%	2311	24.40%
Paternity not acknowledged	27373	13.40%	26106	13.60%	112	15.30%	106	13.30%	114	15.40%	935	9.90%
Adequacy of prenatal care													< 0.0001	0.05
Inadequate	26633	13.10%	75618	39.30%	122	16.60%	187	23.40%	134	18.10%	2769	29.30%
Intermediate	14269	7.00%	25365	13.20%	57	7.80%	89	11.20%	89	12.00%	1033	10.90%
Adequate	78830	38.60%	13762	7.20%	24	3.30%	35	4.40%	34	4.60%	414	4.40%
Adequate plus	64277	31.50%	58787	30.60%	410	55.90%	390	48.90%	395	53.20%	4295	45.40%
Unknown	20048	9.80%	18797	9.80%	120	16.40%	97	12.20%	90	12.10%	944	10.00%
Medicaid													< 0.0001	0.01
Medicaid	96861	47.50%	91165	47.40%	300	40.90%	362	45.40%	319	43.00%	4715	49.90%
Private	88330	43.30%	83149	43.20%	378	51.60%	375	47.00%	387	52.20%	4041	42.70%
Other	9697	4.80%	9244	4.80%	23	3.10%	27	3.40%	20	2.70%	383	4.10%
Missing	9169	4.50%	8771	4.60%	32	4.40%	34	4.30%	16	2.20%	316	3.30%
Smoking during pregnancy													0.002	0.01
No	153347	75.10%	144659	75.20%	506	69.00%	585	73.30%	539	72.60%	7058	74.60%
Yes	50710	24.90%	47670	24.80%	227	31.00%	213	26.70%	203	27.40%	2397	25.40%
Hypertension (prepregnancy gestational eclampsia)													< 0.0001	0.06
Yes	10862	5.30%	182744	95.00%	639	87.20%	712	89.20%	628	84.60%	8472	89.60%
No	193195	94.70%	9585	5.00%	94	12.80%	86	10.80%	114	15.40%	983	10.40%
Sexually transmitted infection													0.004	0.01
Yes	2055	1.00%	1911	1.00%	5	0.70%	16	2.00%	13	1.80%	110	1.20%
No	202002	99.00%	190418	99.00%	728	99.30%	782	98.00%	729	98.20%	9345	98.80%
Previous preterm birth													< 0.0001	0.04
Yes	6321	3.10%	5697	3.00%	66	9.00%	59	7.40%	50	6.70%	449	4.70%
No	197736	96.90%	186632	97.00%	667	91.00%	739	92.60%	692	93.30%	9006	95.30%
BMI category													< 0.0001	0.08
Underweight	9037	4.40%	8812	4.60%	6	0.80%	5	0.60%	5	0.70%	209	2.20%
Normal weight	97666	47.90%	94641	49.20%	177	24.10%	163	20.40%	100	13.50%	2585	27.30%
Overweight	48393	23.70%	45603	23.70%	173	23.60%	156	19.50%	159	21.40%	2302	24.30%
Obese	48961	24.00%	43273	22.50%	377	51.40%	474	59.40%	478	64.40%	4359	46.10%
Weight gain													< 0.0001	0.03
Normal gain	57096	28.00%	54188	28.20%	148	20.20%	170	21.30%	151	20.40%	2439	25.80%
Under gain	36867	18.10%	34032	17.70%	117	16.00%	172	21.60%	157	21.20%	2389	25.30%
Over gain	103203	50.60%	97568	50.70%	444	60.60%	417	52.30%	413	55.70%	4361	46.10%
Missing	6891	3.40%	6541	3.40%	24	3.30%	39	4.90%	21	2.80%	266	2.80%
Preterm birth													< 0.0001	0.06
Full term	188239	92.20%	14341	7.50%	193	26.30%	141	17.70%	133	17.90%	1010	10.70%
Preterm	15818	7.80%	177988	92.50%	540	73.70%	657	82.30%	609	82.10%	8445	89.30%
Macrosomia													< 0.0001	0.05
No	187065	91.70%	176873	92.00%	576	78.60%	663	83.10%	626	84.40%	8327	88.10%
Yes	16992	8.30%	15456	8.00%	157	21.40%	135	16.90%	116	15.60%	1128	11.90%
Infant mortality													< 0.0001	0.01
No	203010	99.50%	191334	99.50%	725	98.90%	789	98.90%	734	98.90%	9428	99.70%
Yes	1047	0.50%	995	0.50%	8	1.10%	9	1.10%	8	1.10%	27	0.30%

PD-I: Pre-pregnancy diabetes-insulin dependent; PD-NI: Pre-pregnancy diabetes-non-insulin dependent; GD-I: Gestational diabetes- insulin dependent; GD-NI: Gestational diabetes-non-insulin dependent.

Table 2 Crude and adjusted relationship of diabetes status with birth outcomes

	Preterm birth				Macrosomia				Infant mortality
	cOR	95%CI	aOR	95%CI	cOR	95%CI	aOR	95%CI	cOR	95%CI	aOR	95%CI
Non-diabetic	ref		ref		ref		ref		ref		ref
PD-I	4.15	3.22, 5.34	2.87	2.19, 3.77	3.12	2.37, 4.11	3.01	2.26, 4.01	1.87	0.66, 5.28	1.30	0.46, 3.72
PD-NI	2.45	1.85, 3.24	1.77	1.31, 2.39	2.32	1.74, 3.10	2.12	1.57, 2.86	1.90	0.71, 5.10	1.35	0.50, 3.67
GD-I	2.54	1.91, 3.39	1.73	1.27, 2.35	2.15	1.58, 2.92	1.96	1.42, 2.70	1.62	0.54, 4.88	1.13	0.37, 3.44
GD-NI	1.41	1.27, 1.56	1.07	0.96, 1.19	1.57	1.42, 1.74	1.53	1.39, 1.70	0.51	0.29, 0.89	0.41	0.23, 0.72

aOR adjustments: Maternal age, race/ethnicity, education, paternity/marital status, adequacy of prenatal care, insurance status, smoking, hypertension, STI, previous preterm birth, body mass index, and weight gain. PD-I: Pre-pregnancy diabetes-insulin dependent; PD-NI: Pre-pregnancy diabetes-non-insulin dependent; GD-I: Gestational diabetes- insulin dependent; GD-NI: Gestational diabetes-non-insulin dependent.