Objective: Racial disparities in pre-existing diabetes (PDM) and gestational diabetes (GDM) remain largely unexplored. We examine national PDM and GDM prevalence trends by race/ethnicity, and the association between these conditions and fetal death. Design: Retrospective cross-sectional analysis Setting: United States Nationwide Inpatient Sample Survey Population/Sample: A total of 69,539,875 pregnancy-related hospitalization from 2002 to 2017 including 674,040 women with PDM (1.0%) and 2,960,797 (4.3%) with GDM. Methods: Joinpoint regression was used to evaluate trends in prevalence. Survey logistic regression was used to evaluate the association between exposures (PDM and GDM) and outcome. Main Outcome Measures: National trends in PDM and GDM prevalence by race/ethnicity, and the association between these conditions and fetal death Results: Overall, the average annual increase in prevalence was 5.2% (95% CI [4.2, 6.2]) for GDM and 1.0% (95% CI [-0.1, 2.0]) for PDM, over the study period. Hispanic (AAPC 5.3; 95% CI [3.6, 7.1]) and NH-Black (AAPC 0.9; 95% CI [0.1, 1.7]) women had the highest average annual percent increase in prevalence of GDM and PDM, respectively. After adjustment, odds of stillbirth were highest for Hispanic (OR 2.41:95% CI [2.23, 2.60]) women with PDM and decreased for women with GDM (OR 0.51;95% CI [0.50, 0.53), irrespective of race/ethnicity. Conclusions and Global Health Implications: PDM and GDM prevalence is increasing in the U.S. with highest average annual percent changes seen among minority women. Further, reasons for variation in occurrence of stillbirths among mothers with PDM and GDM by race/ethnicity are not clear and warrant additional research.