Hildén K, et al. - In this investigation involving 1,455,667 pregnancies, experts aspired to explore if incidence of maternal and neonatal outcomes for women with or without gestational diabetes mellitus (GDM) have changed over time. A population-based cohort study in Sweden involving all singleton pregnancies over the period 1998–2012. Over time, the number of pregnancies increased and GDM overall prevalence was 1%. There was a significantly decreasing trend in incidence per year for large for gestational age (LGA), birthweight z-score and birth trauma for women with GDM. No significant interaction tests were found for maternal characteristics. Although the incidence of SGA increased, there were improvements in pregnancy outcomes for women with GDM between 1998 and 2012. Improvements in the background population were following similar patterns. Inequalities in obstetric results between women with GDM and those without GDM have remained unchanged for 15 years, indicating that this disparity requires new management strategies.