Trends in cardiometabolic conditions and pregnancy outcomes: a retrospective cohort study in South-Eastern Melbourne

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dc.contributor.authorBelsti, Y.
dc.contributor.authorPalmer, K.R.
dc.contributor.authorMoran, L.J.
dc.contributor.authorRolnik, D.L.
dc.contributor.authorGoldstein, R.
dc.contributor.authorMousa, A.
dc.contributor.authorEnticott, J.
dc.contributor.authorTeede, H.J.
dc.date.issued2025
dc.description.abstractObjectives To examine trends in preconception and pregnancy cardiometabolic risk factors and conditions, pregnancy and birth complications, obstetric interventions, and the impact of COVID-19, and to forecast future disease burden. Design A multi-centre retrospective cohort study. Setting A large hospital network with three maternity hospitals serving ethnically diverse populations in Melbourne, Australia. Participants Pregnant women who gave birth between 2016 and 2022. Outcome measures Trends in cardiometabolic conditions, birth complications and obstetric interventions. Results Over 7 years, 63 232 women were included, of whom 40% were nulliparous, and 60.9% were born overseas from 167 countries. From 2016–2022, maternal age (30.2–31.3 years), obesity (21.0%–26.2%), gestational diabetes mellitus (GDM) (15.9%–28.1%) and caesarean delivery (28.5%–37.6%) increased, while average gestational weight gain, premature births and special care admissions declined from 12.6–11.6 kg, 6.3%–4.9% and 24.2%–14.1%, respectively; and was statistically significant (p<0.05). Hypertensive disorders of pregnancy remained stable, fluctuating slightly (6.5% in 2016, 7.6% in 2020, 6.9% in 2022). During the COVID-19 lockdown period, the odds of GDM and induced birth increased by 8.0%, whereas the odds of caesarean section decreased by 5.0%. GDM is forecast to reach 43.0% by 2028. Conclusions Prepregnancy and pregnancy cardiometabolic risk factors and conditions, pregnancy and birth complications, and obstetric interventions increased markedly over 7 years. Despite this, offspring complications, including special care admissions, stillbirths and prematurity, decreased, while pregnancy complications peaked during COVID-19. GDM is forecasted to increase to 43.0% by 2028, posing an unsustainable health and economic burden that necessitates urgent public health initiatives.
dc.description.statementofresponsibilityYitayeh Belsti, Kirsten R Palmer, Lisa J Moran, Daniel L Rolnik, Rebecca Goldstein, Aya Mousa, Joanne Enticott, Helena J Teede
dc.identifier.citationBMJ Open, 2025; 15(10):e101777-1-e101777-11
dc.identifier.doi10.1136/bmjopen-2025-101777
dc.identifier.issn2044-6055
dc.identifier.issn2044-6055
dc.identifier.orcidMoran, L.J. [0000-0001-5772-6484]
dc.identifier.urihttps://hdl.handle.net/2440/148343
dc.language.isoen
dc.publisherBMJ Publishing Group
dc.relation.grantNHMRC
dc.rights© Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ Group.
dc.source.urihttps://doi.org/10.1136/bmjopen-2025-101777
dc.subjectAustralia
dc.subjectCesarean Section
dc.subjectCOVID-19
dc.subjectObesity
dc.subjectPregnancy
dc.subjectPregnancy Complications
dc.subjectPremature Birth
dc.subjectRetrospective Studies
dc.subjectSARS-CoV-2
dc.subjectVictoria
dc.subjectcardiometabolic risk; gestational diabetes trends; pregnancy outcomes; COVID-19 impact
dc.titleTrends in cardiometabolic conditions and pregnancy outcomes: a retrospective cohort study in South-Eastern Melbourne
dc.typeJournal article
pubs.publication-statusPublished

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