RATES AND DETERMINANTS OF PRETERM BIRTH IN PREGNANCIES COMPLICATED BY DIABETES MELLITUS
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This population-based retrospective cohort study involving all singleton births between 1988 and 2009 in Nova Scotia estimated the rate of preterm birth less than 37 weeks and less than 34 weeks among pregnancies complicated by pre-gestational and gestational diabetes mellitus using the Nova Scotia Atlee Perinatal Database (NSAPD). The highest risk of preterm birth less than 37 weeks occurred in women with pre-gestational diabetes (22.0%) compared with gestational diabetes (8.1%) and non-diabetics (4.9%). After adjusting for potential confounders, there was a four-fold increased risk of preterm birth less than 37 weeks in pregnancies complicated by pre-gestational diabetes mellitus compared with non-diabetics (adjusted relative risk [aRR] 4.00, 95% confidence interval [CI] 3.19-5.02) and a nearly two-fold increased risk among women with gestational diabetes (aRR 1.63, 95% CI 1.43-1.85) compared with non-diabetics. Using multivariate regression analysis, determinants of preterm birth among pregnancies complicated by diabetes were identified.