In their article, Melchior et al. present prevalence estimates of gestational diabetes of all statutory insured pregnant women from 2014 to 2015 with a total prevalence of 13.2% (1). The authors contrast their findings with our study analyzing incident cases of gestational diabetes among women insured at a statutory health insurance (AOK Berlin) during 2005 to 2007. The incidence of gestational diabetes was 16% (2).
The authors attribute the differences to a more stringent definition of our study population. Indeed, we used much stricter exclusion criteria, such as exclusion of multiple pregnancies, unclear diagnosis of diabetes, and multiple reimbursement. The aim of our study was not to determine a population-representative prevalence, but to provide a comparative analysis of the gestational diabetes incidence between women of Turkish and German origin. For this purpose, a data set for the period from 2005 to 2007 was used with pregnant women who were insured with AOK Berlin throughout the year, from which we identified all women of Turkish origin using a name-based algorithm (3), and randomly selected women of German origin as a comparison group. One reason for the higher incidence in our study can therefore be the selective composition of the study population. We were able to show that Turkish origin is an independent risk factor for gestational diabetes, especially for young women of Turkish origin with obesity (2). However, an estimation of the gestational diabetes rate in the whole population is only possible to a very limited extent.
In contrast, Melchior et al. use nationwide reimbursement data and can thus provide important representative results on the frequency of gestational diabetes in Germany. In the future, deeper analyses regarding risk differences in gestational diabetes and birth outcomes according to social determinants, such as migration background, would be desirable in order to identify possible risk groups and deficits in care of pregnant women.
Footnotes
Conflict of interest statement
The authors declare that no conflict of interest exists.
References
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