Secular increase in the prevalence of gestational diabetes and its associated adverse pregnancy outcomes from 2014 to 2021 in Hebei province, China

Abstract

ObjectiveWe aimed to investigate the secular prevalence of gestational diabetes mellitus (GDM) and evaluate its adverse pregnancy outcomes among pregnant women in Hebei province, China.MethodsWe analyzed the data from the monitoring information management system for pregnant women in 22 hospitals of Hebei province, China. In this study, 366,212 individuals with singleton live births from 2014 to 2021 were included, of whom 25,995 were diagnosed with gestational diabetes. We described the incidence of common complications and further analyzed the clinical characteristics in GDM patients and the relationship between GDM and adverse pregnancy outcomes.ResultsThe top 3 pregnancy complications in Hebei province are anemia, gestational hypertension, and GDM. The average incidence of GDM was 7.10% (25,995/366,212). The incidence rate of GDM significantly increased from 2014 to 2021 (χ2trend = 7,140.663, P < 0.001). The top 3 regions with GDM incidence were Baoding (16.60%), Shijiazhuang (8.00%), and Tangshan (3.80%). The incidence of GDM in urban pregnant women (10.6%) is higher than that in rural areas (3.7%).The difference between the GDM and Non-GDM groups was statistically significant in terms of maternal age, gravidity, parity, education level, and incidence of pregnancy complications (gestational hypertension, heart diseases, and anemia) (P < 0.05). GDM individuals were at significantly increased risk of most assessed adverse pregnancy outcomes, including premature delivery, Cesarean delivery, uterine inertia, neonatal intensive care unit (NICU) admission, Apgar (activity-pulse-grimace-appearance-respiration) score at 1 min, and macrosomia (P < 0.05). The multivariate logistic regression analysis showed that GDM was an independent risk factor in terms of premature birth, Cesarean delivery, uterine inertia, placental abruption, NICU admission, and macrosomia.ConclusionThe risk of adverse pregnancy outcome in pregnant women with GDM is significantly increased. In order to reduce the occurrence of adverse pregnancy outcomes, effective interventions are needed.

The Effect of 2016 Chinese second-child policy and different maternal age on pregnancy outcomes in Hebei Province, China

“…The risk of GDM in AMA women increased. Previous studies [ 27 – 29 ] showed that the risk of GDM pregnant women delivering macrosomia and LGA infants was significantly higher than that of non-GDM pregnant women. This could also be related to the fact that AMA mothers pay increased attention to nutritional supplementation during pregnancy, resulting in excessive nutrition.…”

Continuous glucose monitoring-derived glycemic metrics and adverse pregnancy outcomes among women with gestational diabetes: a prospective cohort study

“…Previous studies revealed that women with GDM also experienced a higher risk of NICU admission. 24 , 25 Maternal hyperglycemia can lead to fetal hyperinsulinemia, promoting development of insulin-sensitive tissues (i.g., liver, fat, and muscle) but not non-insulin-sensitive tissues (i.g., brain and kidney). 26 The imbalance development of different fetal tissues may lead to poor tolerance to hypoxia in utero and poor adaptability to the external environment.…”

Characteristics of the oral glucose tolerance test in women with different pre-pregnancy body mass index and the effect of gestational diabetes mellitus on twin pregnancy outcomes

“…A multicenter study involving 13 hospitals in China (including multiple pregnancies) showed an incidence of GDM of 17.5% (3002/17,186). 14 But the incidence of GDM varies a large rank in different areas of China, which was demonstrated a GDM incidence of 7.1% in Hebei Province, 15 while 21.00% of Ningbo City in Zhejiang Province and 21.76% of Peking City. 16 17 It is speculated that the possible reasons involve selection bias arising from single-center research.…”