Beschreibung:
<jats:sec><jats:title>Background</jats:title><jats:p>Pre‐existing diabetes in pregnancy is associated with an increased risk of complications. Likewise, living in rural, regional and remote Victoria, Australia, is also associated with poorer health outcomes. There is a gap in the literature with regard to whether Victorian women with pre‐existing diabetes experience a greater risk of adverse pregnancy outcomes compared to their metropolitan counterparts.</jats:p></jats:sec><jats:sec><jats:title>Aim</jats:title><jats:p>Our objective is to compare obstetric and perinatal outcomes for women with pre‐existing diabetes delivering in rural vs metropolitan hospitals in Victoria, Australia.</jats:p></jats:sec><jats:sec><jats:title>Materials and Methods</jats:title><jats:p>Retrospective population‐based study using routinely collected state‐based data of singleton births to women with type 1 and type 2 diabetes who delivered in metropolitan (<jats:italic>n</jats:italic> = 3233) and rural hospitals (<jats:italic>n</jats:italic> = 693) in Victoria, Australia, between 2006–2015. Pearson's χ<jats:sup>2</jats:sup> test, Fisher’s exact test and MannWhitney <jats:italic>U</jats:italic>‐test were used to compare obstetric and perinatal outcomes between metropolitan and rural locations.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Delivery in a rural hospital was associated with higher rates of stillbirth (2.3% vs 1.1%, <jats:italic>P</jats:italic> = 0.027), macrosomia (25.9% vs 16.9%, <jats:italic>P</jats:italic> < 0.001), shoulder dystocia (8.4% vs 3.5%, <jats:italic>P</jats:italic> < 0.001) and admission to the neonatal intensive care unit/special care nursery (73.2% vs 59.3%, <jats:italic>P</jats:italic> < 0.001). Smoking (18.0% vs 8.9%, <jats:italic>P</jats:italic> < 0.001), overweight/obesity (<jats:italic>P</jats:italic> = 0.047) and socioeconomic disadvantage (<jats:italic>P</jats:italic> < 0.001) were more common in rural women.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Women with pre‐existing diabetes who deliver in rural hospitals experience a greater risk of adverse perinatal outcomes and present with increased maternal risk factors. These results suggest a need to improve care for women with pre‐existing diabetes in rural Victoria.</jats:p></jats:sec>