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Identification of gestational diabetes mellitus in European electronic healthcare databases: insights from the ConcePTION project
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Vera Mitter ,
Angela Lupattelli ,
Vjola Hoxhaj,
Constanza L Andaur Navarro ,
Saeed Hayati,
Sandra Lopez-Leon,
Joan K Morris ,
Anja Geldof,
Sue Jordan,
Maarit K Leinonen ,
Visa Martikainen,
Marco Manfrini,
Luca Cammarota,
Amanda Neville,
Laia Barrachina-Bonet ,
Clara Cavero-Carbonell,
Laura García-Villodre,
Anthony Caillet,
Marie Beslay,
Christine Damase-Michel,
Marleen M H J van Gelder ,
Hedvig Nordeng
BMJ Open, Volume: 15, Issue: 10, Start page: e102343
Swansea University Author: Sue Jordan
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© Author(s) (or their employer(s)) 2025. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license.
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DOI (Published version): 10.1136/bmjopen-2025-102343
Abstract
Objective To develop and compare algorithms for identifying gestational diabetes mellitus (GDM) across European electronic healthcare databases and evaluate their impact on the estimated prevalence.Design Multi-national cohort study using routinely collected electronic healthcare dataSetting Nationa...
| Published in: | BMJ Open |
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| ISSN: | 2044-6055 2044-6055 |
| Published: |
BMJ
2025
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| Online Access: |
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| URI: | https://cronfa.swan.ac.uk/Record/cronfa71345 |
| Abstract: |
Objective To develop and compare algorithms for identifying gestational diabetes mellitus (GDM) across European electronic healthcare databases and evaluate their impact on the estimated prevalence.Design Multi-national cohort study using routinely collected electronic healthcare dataSetting National and regional databases in five European countries (Norway, Finland, Italy, Spain and France), in primary and/or secondary care.Participants Pregnancy cohorts resulting in stillbirths or live births between 2009 and 2020, comprising 602 897 pregnancies in Norway, 507 904 in Finland, 374 009 in Italy, 193 495 in Spain and 116 762 in France.Primary and secondary outcomes The primary outcome was the prevalence of GDM identified using six algorithms: (1) Only diagnosis; (2) Diagnosis or prescription; (3) Two diagnoses or prescriptions (2DxRx); (4) Diagnosis including unspecified diabetes in pregnancy or prescription (DxRx broad); (5) Diagnosis excluding pre-existing diabetes in pregnancy or prescription; (6) Registration of GDM in a birth registry (BR).Results The strictest algorithm (2DxRx) resulted in the lowest GDM prevalence, while the broadest (DxRx broad) resulted in the highest, except in France where it was BR. In the Nordic countries, GDM prevalence varied only slightly by algorithm; greater variations were observed in other countries. The prevalence ranged from 3.5% (95% CI: 3.5% to 3.5%) to 4.6% (95% CI: 4.5% to 4.7%) in Norway; 12.1% (95% CI: 12.0% to 12.2%) to 15.8% (95% CI: 15.7% to 15.9%) in Finland, where prevalence was much higher than elsewhere. The prevalence ranged from 1.3% (95% CI: 1.3% to 1.3%) to 5.4% (95% CI: 5.3% to 5.5%) in Italy; 1.6% (95% CI: 1.5% to 1.7%) to 6.2% (95% CI: 6.1% to 6.3%) in Spain; and 1.7% (95% CI: 1.6% to 1.8%) to 5.8% (95% CI: 5.7% to 5.9%) in France.Conclusions In this multinational study, GDM prevalence ranged from 1.3% to 15.8% depending on the algorithm and database. Nordic countries showed smaller differences in prevalence between algorithms, while the other countries showed larger variations, likely due to differences in coding practices, healthcare systems and database coverage. |
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| College: |
Faculty of Medicine, Health and Life Sciences |
| Funders: |
The ConcePTION project has received funding from the Innovative Medicines Initiative 2 Joint Undertaking under grant agreement No 821520. This Joint Undertaking receives support from the European Union’s Horizon 2020 research and innovation programme and EFPIA. |
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10 |
| Start Page: |
e102343 |