| Background and Objectives This study explored the prevalence of gestational diabetes mellitus(GDM)in Chinese pregnant women and identified risk factors for GDM after the implementation of the universal two-child policy.Methods and Study Design Respectively,we use cluster random sampling method to extract the affiliated hospital of Qingdao university Huangdao campus,Development zone people's hospital and Hospital of Traditional Chinese Medicine of Huangdao district.We estimated that this would require a study of 4681 subjects.From January 1,2016 to July 31,4959 women who had been registered within 12 weeks of gestation received a 75-g 2-h oral glucose tolerance test(OGTT)at 24–28 gestational weeks.International Association of Diabetes and Pregnancy Study Group criteria(IADPSG)were used for the diagnosis of gestational diabetes mellitus(GDM).According to the IADPSG criteria,a diagnosis of GDM can be made when any one of the following values is met or exceeded in the 75-g OGTT: 0-h(fasting),?5.10 mmol/L;1-h,?10.00 mmol/L;or 2-h,?8.50 mmol/L.Logistic regression analysis was performed for GDM risk factors by using a backward model.In this analysis,GDM was considered the dependent variable.Associated risk factors for GDM were considered independent variables.Results are presented as arithmetic mean ± standard deviation for quantitative data and percentages for qualitative data.Binary logistic regression was performed to obtain odds ratios(ORs)and 95% confidence intervals(CIs)for risk factors for GDM in univariable and multivariable analyses.Moreover,p values of <0.05 were considered significant.Results 1.From January 1 to July 31,2016,4959 women who had been registered within 12 weeks of gestation received a 75-g 2-h OGTT at 24–28 gestational weeks.According to the data,age of<25 groups included 402,25 to 29 age group included 2436,30 ~ 34 group included 1422,35 years old group included 699,the proportion of 25 to 29 age group was 49.1%,followed by 30 to 34 years old group was 28.7%.2.Pregnant women education mainly concentrated in the undergraduate course and specialized subject,38.4% and 33.2% respectively.The sum of two groups was 71.6%.3.Monthly family income distribution showed that 5000-6999 and 7000-9999,the largest proportion of them were 27.7% and 33.4%,respectively.4.The percentage of first pregnancy pregnant women was 49.80%,followed the percentage of second pregnancy was 33.8%,the percentage of pregnant times of 3 or more was 16.30%,The percentage of one parity was 65%,the percentage of two children and above was 35% of the pregnant woman.5.Among the 4959 pregnant women,the mean gestational ages of the non-GDM and GDM groups were(35.65±2.67)and(35.33±2.62)weeks,respectively.The difference in the gestational ages between the two groups was not statistically significant(p=0.706).The mean maternal age of the GDM group was higher than that of the non-GDM group(32.01 ± 4.32 vs.29.23 ± 3.56 years,p<0.001).The percentage of women with a mean maternal age of ?30 years was higher in the GDM group than in the non-GDM group(63.1% vs.37.1%,p<0.001).The mean weight gain during pregnancy and the prepregnancy BMI were higher in women with GDM than in women without GDM.Table 1 shows that compared with women without GDM,those with GDM were poorly educated,with parity ? 1,multiple pregnancies,and a maternal and paternal history of diabetes.These differences were statistically significant(p<0.05).In addition,the average hemoglobin level was higher during early pregnancy in women with GDM than in women without GDM(123.66 ± 8.23 vs.121.01 ± 7.97 g/L,p=0.003).6.Univariable analysis of binary logistic regression,which was used to detect the traditional risk factors for GDM,revealed the following associated factors: maternal age ?30 years,prepregnancy overweight/obesity,parity ?1,number of pregnancies ?2,and a family history of diabetes.We used multiple logistic regression to adjust for the results,thus yielding Table 3,which shows that age ?30 years,overweight/obesity,and a family history of diabetes in first-degree relatives remained associated with the risk of GDM.However,parity ?1 and multiple pregnancies were no longer significantly associated with GDM.In addition,maternal history of diabetes(OR=3.98,95% CI=2.163–5.5984,p<0.001)was more positively associated with the risk of GDM than was paternal history of diabetes(OR=2.543,95% CI=1.383–4.674,p=0.003).Conclusions Qingdao has an exceptionally high estimated prevalence of GDM.Widelyrecognized risk factors for GDM were advanced age,prepregnancy overweight/obesity,and a family history of diabetes in first-degree relatives.Available options to prevent and manage GDM must be explored.We found that the risk of the GDM increased significantly from the age of 30 with the increase in the age of the mother.The genetic predisposition of maternal diabetes is more closely related to the onset of diabetes in the father than in the GDM. |
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