Prevalence of Pre-Pregnancy Diabetes, Obesity, and Hypertension in Canada

Published:March 23, 2019DOI:



      Pre-existing diabetes mellitus (D), obesity (O), and chronic hypertension (H) can each alter the natural course of pregnancy, especially when they cluster together. Because the prevalence of various combinations of D, O, and H is unknown, the current study was undertaken.


      This population-based cross-sectional study included 506 483 singleton and twin live birth and stillbirth deliveries in Ontario, occurring at ≥20 weeks gestation. All hospital births from 2012 to 2016 were identified in the Better Outcomes Registry and Network information system. The prevalence per 1000 births (95% confidence interval [CI]) of D, O, and H and their combinations were calculated. Prevalence estimates were stratified by twin and singleton gestations, maternal age, parity, and ethnicity (Canadian Task Force Classification II-2).


      During the study period, 5493 women (10.8 per 1000 births; 95% CI 10.6–11.1) had D, 90,177 (178.2; 95% CI 177.0–179.3) had O, and 5667 (11.2; 95% CI 10.9–11.5) had H. The prevalence per 1000 of DO was 4.8, DH 1.0, and OH 5.5, whereas 359 women (0.71 per 1000) had all three. D and H each linearly increased with rising maternal age, along with their combinations, and to some degree with higher parity. The combination of O and H was highest among women of Black ancestry (14.5 per 1000) and lowest among those of Asian ancestry (3.0 per 1000).


      D, O, and H are common conditions in pregnancy, both alone and in various combinations. These data can be used to assess the impact of each state on perinatal health.



      Lorsqu'ils sont présents avant la grossesse, le diabète (D), l'obésité (O) et l'hypertension chronique (H) peuvent en modifier la progression naturelle, surtout s'ils sont présents simultanément. La présente étude a été entreprise pour déterminer la prévalence des diverses combinaisons de D, O et H, actuellement inconnue.


      Cette étude transversale fondée sur la population portait sur 506 483 accouchements s'étant soldés par une naissance vivante ou une mortinaissance d'un seul bébé ou de jumeaux en Ontario, survenus après au moins 20 semaines de gestation. Des données sur toutes les naissances survenues en hôpital de 2012 à 2016 ont été extraites du Registre et réseau des bons résultats dès la naissance. Les prévalences pour 1 000 accouchements (intervalle de confiance [IC] à 95 %) de D, O et H et de leurs combinaisons ont été calculées. Les estimations de la prévalence ont été stratifiées selon le type de grossesse (monofœtale ou gémellaire), l'âge de la mère, la parité et l'origine ethnique (classification II-2 du Groupe d'étude canadien).


      Durant la période à l'étude, nous avons recensé 5 493 femmes enceintes atteintes de diabète (10,8 pour 1 000 accouchements; IC à 95 % : 10,6–11,1), 90 177, d'obésité (178,2; IC à 95 % : 177,0–179,3), et 5 667, d'hypertension chronique (11,2; IC à 95 % : 10,9–11,5). La prévalence pour 1 000 accouchements était de 4,8 pour la combinaison DO, de 1,0 pour DH et de 5,5 pour OH; 359 femmes présentaient les trois affections simultanément (0,71 pour 1 000 accouchements). La prévalence du diabète et de l'hypertension chronique, seuls ou en combinaison, augmentait de façon linéaire avec l'âge maternel, ainsi qu'avec la parité (dans une certaine mesure). La prévalence de la combinaison OH était à son maximum chez les femmes d'ascendance noire (14,5 pour 1000) et à son minimum chez celles d'ascendance asiatique (3,0 pour 1000).


      Le diabète, l'obésité et l'hypertension chronique sont des affections communément observées chez les femmes enceintes, seules ou en combinaison. Les données recueillies ici pourront servir à déterminer l'incidence de chacune sur la santé périnatale.

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