Impact of diabetes on maternal-fetal outcomes in Manitoba: Relationship with ethnic and environmental factors.

PURPOSE: To examine the impact of gestational diabetes mellitus (GDM) on maternal-fetal outcomes in Manitoba. METHODS: The rates of macrosomia, stillbirth, cesarean section (C/S) and shoulder dystocia (S/D) in 324,605 births in Manitoba during 1985-2004, and their relationships with diabetes and demographical factors were analyzed. RESULTS: The incidence of macrosomia, stillbirth, C/S and S/D were 15.3%, 0.57%, 16.0%, and 1.2%, respectively. The rates of macrosomia were elevated in mothers with GDM, type 2 DM (T2DM), rural living, First Nations (FN) status, or >or=35 years of age. Increased rates of stillbirth were associated with women with T2DM, FN status or >or=35 years, but not those with GDM. C/S and S/D were increased in women with GDM or T2DM. FN status in combination with GDM increased the risk of S/D. CONCLUSIONS: GDM, T2DM, advanced maternal age, FN status or rural living affected pregnancy outcomes in Manitoba.