Risk Factors for Gestational Diabetes Mellitus (GDM) in Subsequent Pregnancy Among Women Without GDM History in China: A Multicenter Retrospective Study

Abstract. Objective. This study aimed to determine the likelihood of gestational diabetes mellitus (GDM) in subsequent pregnancy among women without GDM history and to identify risk factors for GDM in subsequent pregnancy. Methods. This retrospective cohort study involved participants who delivered...

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Main Authors: Geng Song, Yumei Wei, Juan Juan, Rina Su, Jianying Yan, Mei Xiao, Xianlan Zhao, Meihua Zhang, Yuyan Ma, Haiwei Liu, Jingxia Sun, Kejia Hu, Huixia Yang
Format: Article
Language:English
Published: Wolters Kluwer Health 2023-01-01
Series:Maternal-Fetal Medicine
Online Access:http://journals.lww.com/10.1097/FM9.0000000000000150
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author Geng Song
Yumei Wei
Juan Juan
Rina Su
Jianying Yan
Mei Xiao
Xianlan Zhao
Meihua Zhang
Yuyan Ma
Haiwei Liu
Jingxia Sun
Kejia Hu
Huixia Yang
author_facet Geng Song
Yumei Wei
Juan Juan
Rina Su
Jianying Yan
Mei Xiao
Xianlan Zhao
Meihua Zhang
Yuyan Ma
Haiwei Liu
Jingxia Sun
Kejia Hu
Huixia Yang
author_sort Geng Song
collection DOAJ
description Abstract. Objective. This study aimed to determine the likelihood of gestational diabetes mellitus (GDM) in subsequent pregnancy among women without GDM history and to identify risk factors for GDM in subsequent pregnancy. Methods. This retrospective cohort study involved participants who delivered twice in same hospital of 18 research centers when delivered the second baby from January 2018 to December 2018. Finally 6204 women were enrolled and 5180 women without GDM history were analyzed further. Women were categorized as non-GDM or GDM based on the blood glucose values of the subsequent pregnancy, and the characteristics and GDM risk of these groups were compared. A univariate analysis of potential risk factors was performed using the Chi-squared test and/or t-test for qualitative or quantitative variables, respectively. Associations with P values <0.1 were chosen to be included in the multivariate binary logistic regression model. Results. In primary analysis of 6204 women, the incidence of GDM in subsequent pregnancy is 48.9% (490/1002) in women with GDM history and 16.1% (835/5202) in women without GDM history. In a further analysis for 5180 women without GDM at index pregnancy, compared with the non-GDM group, the GDM group had a significantly higher age, prepregnancy body mass index, and blood glucose value at each oral glucose tolerance test (OGTT) timepoint (fasting, 1 h and 2 h) during the index and subsequent pregnancies, as well as higher weight retention during the interval between the two pregnancies (P<0.001). Age above 35 years in subsequent pregnancy (odds ratio (OR)=1.540, 95% confidence interval (CI) = 1.257–1.886, P<0.001), macrosomia in index pregnancy (OR=1.749, 95% CI=1.277–2.395, P=0.001), OGTT blood glucose values in index pregnancy (fasting, OR=2.487, 95% CI=1.883–3.285, P<0.001; 1 h, OR=1.142, 95% CI=1.051–1.241, P=0.002; 2 h, OR=1.290, 95% CI=1.162–1.432, P<0.001) and weight retention (OR=1.052, 95% CI=1.035–1.068, P<0.001) were independent risk factors for GDM in subsequent pregnancy. Conclusion. For women without GDM history, GDM risk factors including age, macrosomia history, OGTT value, and weight retention, these can be evaluated before a subsequent pregnancy. Early warning and interventions are needed for women at high risk.
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spelling doaj-art-59ebc6ede90a4029a7d4d5346189e4fc2025-08-20T03:48:23ZengWolters Kluwer HealthMaternal-Fetal Medicine2096-69542641-58952023-01-015191510.1097/FM9.0000000000000150202301000-00003Risk Factors for Gestational Diabetes Mellitus (GDM) in Subsequent Pregnancy Among Women Without GDM History in China: A Multicenter Retrospective StudyGeng Song0Yumei Wei1Juan Juan2Rina Su3Jianying Yan4Mei Xiao5Xianlan Zhao6Meihua Zhang7Yuyan Ma8Haiwei Liu9Jingxia Sun10Kejia Hu11Huixia Yang121 Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China1 Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China1 Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China1 Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, China3 Department of Obstetrics and Gynecology, Fujian Province Maternal and Child Health Hospital, Fuzhou 350005, China4 Department of Obstetrics and Gynecology, Maternal and Child Health Hospital of Hubei Province, Wuhan 430064, China5 Department of Obstetrics and Gynecology, Zhengzhou University First Affiliated Hospital, Zhengzhou 450052, China6 Department of Obstetrics and Gynecology, Taiyuan Maternal and Child Health Hospital, Taiyuan 030012, China7 Department of Obstetrics and Gynecology, Shandong University Qilu Hospital, Jinan 250063, China8 Department of Obstetrics and Gynecology, Hainan General Hospital, Haikou 570311, China9 Department of Obstetrics and Gynecology, First Affiliated Hospital of Harbin Medical University, Harbin 150007, China10 Department of Obstetrics and Gynecology, Beijing Shunyi District Hospital, Beijing 101312, China.1 Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing 100034, ChinaAbstract. Objective. This study aimed to determine the likelihood of gestational diabetes mellitus (GDM) in subsequent pregnancy among women without GDM history and to identify risk factors for GDM in subsequent pregnancy. Methods. This retrospective cohort study involved participants who delivered twice in same hospital of 18 research centers when delivered the second baby from January 2018 to December 2018. Finally 6204 women were enrolled and 5180 women without GDM history were analyzed further. Women were categorized as non-GDM or GDM based on the blood glucose values of the subsequent pregnancy, and the characteristics and GDM risk of these groups were compared. A univariate analysis of potential risk factors was performed using the Chi-squared test and/or t-test for qualitative or quantitative variables, respectively. Associations with P values <0.1 were chosen to be included in the multivariate binary logistic regression model. Results. In primary analysis of 6204 women, the incidence of GDM in subsequent pregnancy is 48.9% (490/1002) in women with GDM history and 16.1% (835/5202) in women without GDM history. In a further analysis for 5180 women without GDM at index pregnancy, compared with the non-GDM group, the GDM group had a significantly higher age, prepregnancy body mass index, and blood glucose value at each oral glucose tolerance test (OGTT) timepoint (fasting, 1 h and 2 h) during the index and subsequent pregnancies, as well as higher weight retention during the interval between the two pregnancies (P<0.001). Age above 35 years in subsequent pregnancy (odds ratio (OR)=1.540, 95% confidence interval (CI) = 1.257–1.886, P<0.001), macrosomia in index pregnancy (OR=1.749, 95% CI=1.277–2.395, P=0.001), OGTT blood glucose values in index pregnancy (fasting, OR=2.487, 95% CI=1.883–3.285, P<0.001; 1 h, OR=1.142, 95% CI=1.051–1.241, P=0.002; 2 h, OR=1.290, 95% CI=1.162–1.432, P<0.001) and weight retention (OR=1.052, 95% CI=1.035–1.068, P<0.001) were independent risk factors for GDM in subsequent pregnancy. Conclusion. For women without GDM history, GDM risk factors including age, macrosomia history, OGTT value, and weight retention, these can be evaluated before a subsequent pregnancy. Early warning and interventions are needed for women at high risk.http://journals.lww.com/10.1097/FM9.0000000000000150
spellingShingle Geng Song
Yumei Wei
Juan Juan
Rina Su
Jianying Yan
Mei Xiao
Xianlan Zhao
Meihua Zhang
Yuyan Ma
Haiwei Liu
Jingxia Sun
Kejia Hu
Huixia Yang
Risk Factors for Gestational Diabetes Mellitus (GDM) in Subsequent Pregnancy Among Women Without GDM History in China: A Multicenter Retrospective Study
Maternal-Fetal Medicine
title Risk Factors for Gestational Diabetes Mellitus (GDM) in Subsequent Pregnancy Among Women Without GDM History in China: A Multicenter Retrospective Study
title_full Risk Factors for Gestational Diabetes Mellitus (GDM) in Subsequent Pregnancy Among Women Without GDM History in China: A Multicenter Retrospective Study
title_fullStr Risk Factors for Gestational Diabetes Mellitus (GDM) in Subsequent Pregnancy Among Women Without GDM History in China: A Multicenter Retrospective Study
title_full_unstemmed Risk Factors for Gestational Diabetes Mellitus (GDM) in Subsequent Pregnancy Among Women Without GDM History in China: A Multicenter Retrospective Study
title_short Risk Factors for Gestational Diabetes Mellitus (GDM) in Subsequent Pregnancy Among Women Without GDM History in China: A Multicenter Retrospective Study
title_sort risk factors for gestational diabetes mellitus gdm in subsequent pregnancy among women without gdm history in china a multicenter retrospective study
url http://journals.lww.com/10.1097/FM9.0000000000000150
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