Incidence and Risk Factors of Gestational Diabetes Mellitus: A Prospective Cohort Study in Qingdao, China

Abstract

Background: Obesity and maternal age are the two most important factors independently affecting the risk of gestational diabetes mellitus (GDM). However, the age differences in the association between obesity and GDM remain unclear. The objectives of this cohort study included: (1) to determine the current incidence of GDM in Qingdao; and (2) to evaluate the risk factors for GDM, such as the interaction between pre-pregnancy body mass index (BMI) and age. Methods: The cohort included 17,145 pregnant women who registered at 15 to 20 gestational weeks from August 1, 2018, to March 1, 2019. A 75-g 2-h oral glucose tolerance test (OGTT) was conducted for each participant at 24-28 gestational weeks. The age-adjusted incidence of GDM was calculated using logistic regression. Multivariate logistic regression analysis was used to identify risk factors. Interaction between age (reference group <30 years) and BMI (reference group <25 kg/m 2) was determined using strata-specific analysis. Results: The incidence and age-adjusted incidence of GDM in Qingdao were 17.42 and 17.45%, respectively. The incidence of GDM appeared to increase steadily with age in all pre-pregnancy BMI groups (all P < 0.05). Older age (≥30 years), gestational BMI gain from pre-pregnancy to 15-20 weeks of gestation, history of GDM and thyroid diseases were risk factors for GDM. There were significant interactions between pre-pregnancy BMI and age (P < 0.05) after adjustment for other confounders. The odds ratio (OR) of pre-pregnancy BMI ≥ 30 kg/m 2 at the age of <30 years, 30-34 years and ≥35 years was 1.30 (95% CI: 0.74-2.28, P = 0.36), 3.21 (95% CI: 2.28-4.52, P < 0.0001) and 1.55 (95% CI: 1.02-2.36, P = 0.0424), respectively. This indicated that pre-pregnancy BMI ≥ 30 kg/m 2 had a stronger effect on GDM in the group aged 30-34 years than those under 30 years old. Conclusions: The incidence of GDM was high in Qingdao. Overweight and obesity prior to pregnancy, gestational BMI gain from conception to 15-20 weeks of gestation and older age were correlated with an increased risk of GDM. Public health measures may be helpful to prevent excessive gestational weight gain.

Association of Gestational Diabetes Mellitus with Adverse Pregnancy Outcomes and Its Interaction with Maternal Age in Chinese Urban Women

“…GDM has become a major health concern in pregnant women, and its prevalence has been dramatically increasing worldwide. According to the data from the International Diabetes Federation, GDM was estimated to affect 13.2% of live births in 2019 [2], while the prevalence of GDM ranges from 9.3% to 19.7% in different areas of China and the societal economic burden of GDM was $5.59 billion in 2015 at the Chinese national level [3][4][5][6]. GDM has been associated with a number of short-and long-term perinatal outcomes not only for the mothers but also for their offspring.…”

Association of Gestational Diabetes Mellitus With Adverse Pregnancy Outcomes and Its Interaction With Maternal Age in Chinese Urban Women

“…According to the data from the International Diabetes Federation, GDM was estimated to affect 13.2% of live births in 2019 [2], while the prevalence of GDM ranges from 9.3-19.7% in different areas of China and the societal economic burden of GDM was $ 5.59 billion in 2015 at the Chinese national level [3][4][5][6].…”

Frequency of caesarean section in diabetic vs. non diabetic females undergoing induction of labour at term

“…However different ethnic groups have different prevalence. 4,10,11 Study conducted in Bahawalpur concluded the risk of gestational diabetes was 22.58% in obese women which were higher than in non-obese women(6.45%). 12 Another study conducted at Khyber Teaching Hospital, Peshawar also found advanced maternal age, BMI, previous history of macrosomia being the risk factors for increased frequency of gestational diabetes.…”