Recurrence Of Gestational Diabetes In Primiparous Women In Northern Zhejiang,China:Risk Factors And Implications

Researeh purposes:To determine the recurrence rate of GDM during a subsequent pregnancy among women who had GDM during the first pregnancy,and to identify the risk factors associated with the probability of recurrence,as well as its influence on pregnancy outcomes,in north Zhejiang of China,after the adjustment of childbirth policy.Research objects and methods:1.Objects:A retrospective longitudinal study was performed in north Zhejiang(Jiaxing Maternal and Child Health Hospital),China,of women who delivered two sequential live singleton infants and were diagnosed as having GDM in the index pregnancy between the years of 2011 and 2017.A total of 128 women were included.2.Methods:The patients were divided into recurrent group and non-recurrent group,and The age of index and subsequent pregnancy,height,pre-pregnancy and prenatal weight,weight gain during pregnancy,biochemical parameters,number of visits during pregnancy,family history,educational level,mode of delivery,complications of childbirth,as well as neonatal birth weeks,birth weight and lmin Apger score,were collected and analyzed.SPSS 19.0 was used for statistical analysis.Results:1.According to the 2011 International Association of the Diabetes and Pregnancy Study IADPSG diagnostic criteria for gestational diabetes mellitus,the incidence of gestational diabetes mellitus in northern Zhejiang was 11.02%(1128/10236).The recurrence rate of gestational diabetes mellitus in northern Zhejiang was 43.75%(56/128).2.The age of subsequent pregnancy(OR=8.663,95%CI 1.532?48.993),weight gain during pregnancy(OR=1,491,95%CI 1.203?1.848),inter-pregnancy interval(OR=10.657,95%Cl 2.137?53.140),macrosomia during the index pregnancy(OR=10.091,95%CI 1.605?63.457)were risk factors for gestational diabetes mellitus recurrence.3.For those women with recurrent gestational diabetes mellitus,GDM developed earlier compared to that in index pregnancy(p<0.05)and the birth of a large number of children at the beginning of pregnancy,pre-pregnancy preterm children(less than gestational age children)and low birth weight children Occurrence increased compared with early pregnancy.Conclusion:The recurrence rate of diabetes mellitus is high in the northern Zhejiang.The age of subsequent pregnancy,The second child era should strengthen the management of gestational diabetes mellitus,improve their prognosis and adverse pregnancy outcome,in order to achieve the purpose of high-quality fertility.