Estimating the Prevalence of Gestational Diabetes Mellitus in Iowa using the Birth Certificate and Medicaid Claims Data

Gestational diabetes mellitus (GDM) is a common and rapidly increasing comorbidity of pregnancy. The prevalence of GDM varies widely among different groups. Data on the prevalence of GDM are needed at the state level, particularly for different population subgroups, including women living in rural or urban areas. Prevalence data can help monitor trends, design health care services, and develop effective prevention strategies. Currently, minimal GDM data monitoring is reported statewide. The current study objective is to report GDM prevalence and trends among population subgroups in Iowa.

We calculated GDM prevalence using 2013 Iowa Birth Certificate (IBC) data. To further explore GDM, we used Medicaid claims data to calculate the prevalence of GDM among Medicaid-reimbursed deliveries in 2013. Additionally, among those diagnosed with GDM, we examined whether women received the ACOG recommended postpartum diabetes screening.

The prevalence of GDM calculated from the 2013 IBC data was 6.7%.  Of women with GDM, 41.7% had a Medicaid reimbursed delivery compared to 38.8% of non-GDM women. Based on IBC data, we did not find a significant difference in GDM  prevalence among women living in rural or urban areas.

GDM is likely underreported on the birth certificate. We used Medicaid paid claims data to confirm GDM prevalence among women with Medicaid-reimbursed deliveries. Understanding GDM burden in Iowa is of particular importance since these women may experience increased comorbidities and potentially longer hospital stays. Services, such as care coordination, can link GDM women with evidence-based programs to prevent the development of diabetes and comorbidities.