Trends and Projections of the Prevalence of Diabetes Mellitus in Pregnancy and Fetal-Neonatal Metabolic Disorders, 2010-2035: A Nationwide Population-Based Study from Hungary.

Objectives: Diabetes in pregnancy represents a significant public health concern with established impacts on both maternal and fetal health outcomes. Our aim was to evaluate the epidemiology of diabetes mellitus in pregnancy (DMP) and specific fetal and neonatal transient metabolic disorders (FNTMDs) in Hungary between 2010 and 2024, as well as to project future trends through to 2035. Methods: We carried out a quantitative, retrospective study using nationwide real-world data from the Hungarian 'Pulvita' Health Data Warehouse. ICD-10 codes O24.0-O24.9 (DMP) and P70.0-P70.9 (FNTMDs) were included. Annual patient numbers, the number of hospital days, and the number of DMP patients per 1000 women aged 15-49, as well as the number of FNTMD patients per 1000 live births, were analyzed with joinpoint regression analysis and different forecasting models to project future prevalence up to 2035. Results: Despite a 14.2% decrease in live births, DMP cases increased significantly (54.9% inpatient, 26.6% outpatient), with GDM incidence per thousand reproductive-age women rising by 85.7%. FNTMD cases showed similar trends, with GDM-related infant syndromes more than doubling (154% increase). Projections indicate that DMP prevalence could reach 4.60 per 1000 reproductive-age women by 2035, while FNTMD cases show varying trends between inpatient (increasing) and outpatient (stabilizing) care. Conclusions: These findings demonstrate a continuing upward trend in diabetes-related pregnancy complications, despite shorter hospital stays, suggesting an urgent need for enhanced preventive programs and specialized care service planning.