Ditte Mølgaard-Nielsen, Vera Mitter, Angela Lupattelli, Vjola Hoxhaj, Constanza L Andaur Navarro, Saeed Hayati, Sandra Lopez-Leon, Joan K Morris, Anja Geldof, Susan 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
{"title":"欧洲电子保健数据库中妊娠期糖尿病的鉴定：来自ConcePTION项目的见解。","authors":"Ditte Mølgaard-Nielsen, Vera Mitter, Angela Lupattelli, Vjola Hoxhaj, Constanza L Andaur Navarro, Saeed Hayati, Sandra Lopez-Leon, Joan K Morris, Anja Geldof, Susan 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","doi":"10.1136/bmjopen-2025-102343","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To develop and compare algorithms for identifying gestational diabetes mellitus (GDM) across European electronic healthcare databases and evaluate their impact on the estimated prevalence.</p><p><strong>Design: </strong>Multi-national cohort study using routinely collected electronic healthcare data SETTING: National and regional databases in five European countries (Norway, Finland, Italy, Spain and France), in primary and/or secondary care.</p><p><strong>Participants: </strong>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.</p><p><strong>Primary and secondary outcomes: </strong>The primary outcome was the prevalence of GDM identified using six algorithms: (1) Only diagnosis; (2) Diagnosis or prescription; (3) Two diagnoses or prescriptions (<i>2DxRx</i>); (4) Diagnosis including unspecified diabetes in pregnancy or prescription (<i>DxRx broad</i>); (5) Diagnosis excluding pre-existing diabetes in pregnancy or prescription; (6) Registration of GDM in a birth registry (<i>BR</i>).</p><p><strong>Results: </strong>The strictest algorithm (<i>2DxRx</i>) resulted in the lowest GDM prevalence, while the broadest (<i>DxRx broad</i>) resulted in the highest, except in France where it was <i>BR</i>. 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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 10","pages":"e102343"},"PeriodicalIF":2.3000,"publicationDate":"2025-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Identification of gestational diabetes mellitus in European electronic healthcare databases: insights from the ConcePTION project.\",\"authors\":\"Ditte Mølgaard-Nielsen, Vera Mitter, Angela Lupattelli, Vjola Hoxhaj, Constanza L Andaur Navarro, Saeed Hayati, Sandra Lopez-Leon, Joan K Morris, Anja Geldof, Susan 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\",\"doi\":\"10.1136/bmjopen-2025-102343\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To develop and compare algorithms for identifying gestational diabetes mellitus (GDM) across European electronic healthcare databases and evaluate their impact on the estimated prevalence.</p><p><strong>Design: </strong>Multi-national cohort study using routinely collected electronic healthcare data SETTING: National and regional databases in five European countries (Norway, Finland, Italy, Spain and France), in primary and/or secondary care.</p><p><strong>Participants: </strong>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.</p><p><strong>Primary and secondary outcomes: </strong>The primary outcome was the prevalence of GDM identified using six algorithms: (1) Only diagnosis; (2) Diagnosis or prescription; (3) Two diagnoses or prescriptions (<i>2DxRx</i>); (4) Diagnosis including unspecified diabetes in pregnancy or prescription (<i>DxRx broad</i>); (5) Diagnosis excluding pre-existing diabetes in pregnancy or prescription; (6) Registration of GDM in a birth registry (<i>BR</i>).</p><p><strong>Results: </strong>The strictest algorithm (<i>2DxRx</i>) resulted in the lowest GDM prevalence, while the broadest (<i>DxRx broad</i>) resulted in the highest, except in France where it was <i>BR</i>. 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.</p><p><strong>Conclusions: </strong>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.</p>\",\"PeriodicalId\":9158,\"journal\":{\"name\":\"BMJ Open\",\"volume\":\"15 10\",\"pages\":\"e102343\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2025-10-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMJ Open\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1136/bmjopen-2025-102343\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMJ Open","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/bmjopen-2025-102343","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
Identification of gestational diabetes mellitus in European electronic healthcare databases: insights from the ConcePTION project.
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 data SETTING: 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.
期刊介绍：
BMJ Open is an online, open access journal, dedicated to publishing medical research from all disciplines and therapeutic areas. The journal publishes all research study types, from study protocols to phase I trials to meta-analyses, including small or specialist studies. Publishing procedures are built around fully open peer review and continuous publication, publishing research online as soon as the article is ready.
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