Gestational diabetes has become increasingly common in Sweden, particularly among women with lower levels of education, lower incomes, and women born outside Sweden. This is shown in a new study from Karolinska Institutet published in The Journal of Clinical Endocrinology & Metabolism. The study also shows that the relationship between gestational diabetes and complications during pregnancy and childbirth differs between population groups.
Researchers analysed data from 938,798 pregnancies in Sweden between 2015 and 2023. By linking information from the Swedish Pregnancy Register with national registers, they investigated how gestational diabetes is associated with factors such as educational level, income, and region of birth.
The prevalence of gestational diabetes increased from 1.5 percent in 2015 to 6.6 percent in 2023. The increase was greatest among women born outside Sweden, women with lower educational attainment, and women with lower incomes.
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“Our results show clear differences in the prevalence of gestational diabetes between social groups in Sweden. This suggests that preventive efforts need to take both social and demographic factors into account,” says Nina Kaegi-Braun , physician and researcher at the Department of Medicine, Huddinge , Karolinska Institutet.
Increased risk of complications
The study also showed that women with gestational diabetes were more likely to experience pregnancy-related complications, such as hypertension during pregnancy, as well as complications during childbirth. The association was stronger among women with lower educational attainment than among women with post-secondary education. However, no clear differences between income groups were observed when researchers analysed the burden of complications.
The researchers also found that the relationship between gestational diabetes and complications varied according to a woman’s region of birth. Relatively speaking, the association between gestational diabetes and certain complications was weaker among several groups of foreign-born women than among Swedish-born women. At the same time, some groups, including women born in Africa and Southeast Asia, experienced higher overall rates of these complications.
“The findings were somewhat unexpected and highlight the complexity of gestational diabetes and its consequences across different population groups. More research is needed to understand which factors in healthcare pathways and living conditions may contribute to these differences, particularly among women born outside Sweden,” says Nina Kaegi-Braun.
A strength of the study is its large sample size and nationwide coverage. However, the researchers emphasize that the findings are based on registry data and that information on certain factors, such as physical activity, sleep, and social support, was not available. In addition, screening practices and diagnostic criteria for gestational diabetes varied between regions during the study period.
The study was conducted by researchers from Karolinska Institutet in collaboration with Linköping University and Linköping University Hospital. The research was funded by the Swiss National Science Foundation, the Swedish Research Council (Vetenskapsrådet), and Forte. The researchers report no conflicts of interest.
Publication
Kaegi-Braun N, Söderström Shields E, Ersson M, Strandberg R, Papapanagiotou V, Lilliecreutz C, Löf M. Journal of Clinical Endocrinology & Metabolism, September 2026, doi: 10.1210/clinem/dgag366.
