Gestational diabetes & diabetes in pregnancy
Maternal Diabetes, Fetal Growth, and Stillbirth Risk: A Population-Wide Retrospective Cohort Study From Victoria, Australia
Authors' conclusion
In our cohort, gestational diabetes was associated with a lower stillbirth risk compared with no diabetes, which potentially can be explained by increased monitoring and earlier iatrogenic delivery. Preexisting diabetes was associated with a higher overall risk of stillbirth, with macrosomic fetuses in the >97th centile representing a particularly high-risk group requiring close monitoring.
Study context
- Population
- All singleton births in Victoria, Australia, 2009–2020; 100,856 pregnancies (11.7%) complicated by diabetes
- Participants
- 860,042 births
- Exposure
- Diabetes in pregnancy vs no diabetes
- Outcome
- Stillbirth risk
Methodological detailspopulation-wide, linked perinatal and diabetes data
- Population-wide
- Linked perinatal and diabetes data
Main finding
As reported in the abstract
Stillbirth
Each group vs no diabetesRelative risk (95% CI)
GDM diet-controlled
0.75(0.64–0.89)
GDM insulin-controlled
0.37(0.25–0.50)
Preexisting diabetestrend persisted across all gestational ages and birth weights
2.68(2.01–3.56)
Observational data: associations, not effects.
Further findings
| Outcome | RR (95% CI) | |
|---|---|---|
| Stillbirth in infants >97th centileT1Dvs No diabetes | 3.96 (1.23–12.76) | |
| Stillbirth in infants >97th centileT2Dvs No diabetes | 4.02 (1.71–9.47) | |
| 0.050.21520Relative risk (log scale) |
| Outcome | No diabetes |
|---|---|
| Gestation at birth | median 39.4 weeks |
| Iatrogenic births | 44% |
- Gestation at birth: Diabetes in pregnancy median 38.7 weeks
- Iatrogenic births: Diabetes in pregnancy 65%
Original publication
Maternal Diabetes, Fetal Growth, and Stillbirth Risk: A Population-Wide Retrospective Cohort Study From Victoria, Australia. Diabetes Care. Published 3 September 2025. doi:10.
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