Risk Factors For Recurrent Gestational Diabetes Mellitus

Objective:Discussion on Inner Mongolia before a patient pregnant women with gestational diabetes mellitus(GDM)second pregnancy relapse rate,analysis of risk factors for GDM recurrence.Provide clinical reference for the prevention,diagnosis and treatment of GDM recurrence,reduce GDM recurrence,and minimize the adverse pregnancy outcome of mother and infant.For the prevention,diagnosis and treatment of recurrent GDM provide clinical reference,reduce GDM recurrence,minimize maternal adverse pregnancy outcomes.Methods:1.Analytical epidemiological method of retrospective study was adopted.2.From January 2010 to December 2020,380 pregnant and parturients with two consecutive deliveries of single fetus,complete cases,history of gestational diabetes in their first pregnancy and normal glucose metabolism after postpartum reexamination in the Affiliated Hospital of Inner Mongolia Medical University were selected as the subjects.3.All the 380 subjects in the study had abnormal glucose metabolism in the previous pregnancy,but returned to normal after delivery.They were divided into two groups according to whether the pregnancy was complicated with abnormal glucose metabolism,namely recurrent GDM group and control group.4.Through medical records and record 2 times to be obtained and clinical features of pregnancy,including maternal social demographic data,the previous and the gestational age,previous pregnancy and blood sugar control method,height,body weight,the entire pregnancy weight before childbirth,mid pregnancy(including:the early stages of pregnancy and late pregnancy),childbirth way,family history,cultural degree,the number of,glycosylated hemoglobin(HbAlc),etc.,using SPSS24.0 for statistical analysis.Results:(1)Among 380 pregnant women with a history of GDM in the previous pregnancy,145 of them had a recurrence of GDM in the second pregnancy,with a recurrence rate of 38.2%(145/380).(2)Comparison of two pregnancies in the recurrent GDM group:FPG,lhPG,2hPG and HbA1c values of this pregnancy and the previous pregnancy in the recurrent GDM group were not statistically significant(P>0.05).The proportion of abnormal FPG+1HPG and/or 2HPG in this pregnancy was higher than that in the previous pregnancy,with statistical significance(P=0.031<0.05).(3)recurrent GDM group compared with control group the pregnancies:recurrent GDM group age 35 years old,or pregnancy BMI 25 kg/m2,immediate family members or family history of diabetes during pregnancy weight growth rate is higher than the control group,with statistical significance(P<0.05),the time interval between two times pregnancy,pregnancy weight no difference between the two groups(P>0.05),no statistical significance.(4)GDM of the current pregnancy recurrence was taken as the dependent variable,and the indicators of statistical significance in univariate analysis were taken as the independent variable.Among them,the limit of weight gain during pregnancy,1hPG and 2hPG was the mean value of all subjects.Logistic regression analysis showed that:Age≥35 years old(OR=3.679,95%CI 2.186-6.193),BMI≥25kg/m2 before pregnancy(OR=2.074,95%CI 1.203-3.576),family history of diabetes in immediate family(OR=2.646,95%CI 1.533-4.566),poor blood glucose control in previous pregnancy(OR=1.916,95%CI 1.084-3.387),and macantomorbiosis in previous pregnancy(OR=3.753,95%CI 1.472-9.567),previous pregnancy 2HPG>8.67(OR=3.610,95%CI 1.657-7.863),previous pregnancy 1HPG OR(and)2HPG abnormal(OR=0.265,95%CI 0.101-0.693),previous pregnancy HbA1c≥5.5%(OR=5.142,95%CI 2.782-9.501)and pregnancy weight gain≥13.21(OR=1.916,95%CI 1.137-3.228)were risk factors for GDM recurrence in this pregnancy(P<0.05).There was no correlation between 1HPG≥9.79 in previous pregnancy,abnormal FPG+1HPG or(and)2HPG in previous pregnancy and GDM recurrence in this pregnancy.Conclusion:In this study,from January 2010 to December 2020,the recurrence rate of GDM in our hospital was 38.2%(145/380).In China,the recurrence rate of GDM ranged from 33%to 69%,and women with GDM had a higher risk of GDM recurrence in the next pregnancy.Age≥35 years old,pre-pregnancy BMI≥25kg/m2,immediate family history of diabetes mellitus,poor blood glucose control in the previous pregnancy,large child in the previous pregnancy,2HPG≥8.67 in the previous pregnancy,1HPG or(and)2HPG abnormality in the previous pregnancy,HbAlc≥5.5%in the previous pregnancy,pregnancy weight gain≥13.21 in the previous pregnancy were all high risk factors for GDM recurrence in this pregnancy(P<0.05).The risk of future metabolic diseases of the mother and her offspring will be increased by the influence of GDM.Such pregnant women should carry out effective management around pregnancy according to their high risk factors,including before pregnancy,during pregnancy and after delivery,so as to reduce the recurrence rate of GDM in the second pregnancy and avoid the adverse pregnancy consequences brought by GDM to the mother and child.