Pregnancy-related diabetes, hypertension on the rise in N.B., report says

More New Brunswick women are getting gestational diabetes and hypertension during pregnancy, as birthing age rises and birth rates decline.

According to PerinatalNB's annual report, there was a significant increase in the number of New Brunswickers who developed diabetes during pregnancy, and a slight increase in the number developing hypertension during pregnancy.

The increased gestational diabetes rates could be connected to a high rate of obesity and higher age, said PerinatalNB medical director Dr. Lynn Murphy-Kaulbeck.

"We do have … a higher percentage of the overall population, of women, with obesity," Murphy-Kaulbeck told Information Morning Fredericton.

"Overall when the age of mothers is increasing at the time of delivery, then you're going to expect more of these problems. We all have increasing medical problems as we age."

The report said fewer women between the ages of 20 and 24, and more women age 35 or older gave birth in the year under study, 2020-21. The majority were between the ages of 25 and 34.

Murphy-Kaulbeck said the report's goal is to find where service is lacking and guide government and health authorities to make policies to address those gaps.

She said with factors such as smoking, alcohol and cannabis use during pregnancy, obesity and hypertension should all be addressed proactively rather than reactively.

This means shifting focus to promoting a healthy lifestyle from a young age, reaching children and teens before habits set in.

"Regardless of age, I think the most important message is to be as healthy as possible, and I think overall we need to look at social determinates of health, healthy lifestyle, look early and start to really say 'how do we get at children and teens,'" she said.

Smoking, alcohol, cannabis

The rate of smoking during pregnancy has increased, Murphy-Kaulbeck said, and is much higher than the national average. 

"What programs do we offer when women come in and say they are smokers?" she said. "Do we have any programs to address that? No."

Alcohol use during pregnancy has stayed steady at around one per cent, which is much lower than the national average of 10 per cent. Cannabis use during pregnancy increased by two per cent from 2019-20, the report says, and primary care providers must remember to address the risk of using cannabis while pregnant. 

The report also said an increasing number of babies born in the province are ending up in the neonatal intensive care unit.

NICU admission rates are between 15 and 37 per cent above the national average depending on the hospital, the report said. Murphy-Kaulbeck said this is something that can be addressed with policy.

For example, she said, the Moncton Hospital decreased its NICU admission rates significantly over the previous year.  Babies were kept in that unit for observation, and not necessarily because they were having medical complications.

She said that increased resources to postpartum units and giving nurses enough resources could automatically decrease the number of NICU admissions.

"We need to look at how we can keep the mother and baby together," she said. "There are babies that are going into NICU, that if we had resources on the birth ward, they can stay together."

Birth rates in New Brunswick continue to trend down, according to the report. The province is down 400 births in the five years ending in 2020-21, and 1,000 over the previous 10 years.