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Research
Association of Gestational Diabetes Mellitus With Adverse Pregnancy Outcomes and Its Interaction With Maternal Age in Chinese Urban Women
Xueyin Wang
Peking University First Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0003-4461-324X
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This work is licensed under a CC BY 4.0 License. Read Full License
Background: The prevalence of gestational diabetes mellitus (GDM) has been dramatically increasing worldwide. The aims of this study were to examine associations of GDM with pregnancy outcomes in Chinese urban women, and to evaluate the interaction between GDM and other major risk factors for the risk of adverse pregnancy outcomes.
Methods: A retrospective analysis included 8,844 women who delivered live singletons at ≥28 weeks of gestation between June 2012 and March 2013 among Chinese urban women. Structured questionnaires were used to collect the information on demographic characteristics, lifestyle behavior, medical history and pregnancy outcomes. The diagnosis of GDM was made between 24 and 28 gestational weeks according to the International Association of Diabetes and Pregnancy Study Groups criteria. Logistic regression models were used to assess the association of GDM with pregnancy outcomes, and to examine the interaction between GDM and other major risk factors including maternal age, prepregnancy body mass index and gestational weight gain for the risk of pregnancy outcomes.
Results: 13.9% of women were diagnosed with GDM. We found that GDM was associated with higher risk of cesarean delivery (Odds Ratio [OR] =1.69, 95% CI [confidence interval]: 1.48-1.92), preterm birth (OR=1.32, 95% CI: 1.07-1.64), macrosomia (OR=1.69, 95% CI: 1.34-2.13) and large-for-gestational age (LGA, OR=1.43, 95% CI: 1.18-1.73) after adjustment for potential confounders. We also observed the interaction between GDM and maternal age for the risk of cesarean delivery (P for interaction = 0.025), and the prevalence of cesarean delivery was higher in women with GDM than those unaffected of GDM regardless of maternal age (age <35 years: 58.5% vs. 44.3%; age ≥35 years: 67.7% vs. 64.3%). Women aged ≥35 years and above and having GDM had a 2.10-fold increased risk of cesarean delivery compared to those who was under 35 years old and did not having GDM (OR=2.10, 95% CI: 1.48-2.93).
Conclusions: GDM was associated with increased risk of cesarean delivery, preterm birth, macrosomia and LGA in Chinese urban women, and there was the interaction between GDM and maternal age for the risk of cesarean delivery.
Keywords
gestational diabetes mellitus, pregnancy outcomes, maternal age, cesarean section, preterm birth, large-for-gestational age, macrosomia
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- SupplementalTables.docx
Table S1. Distribution of gestational diabetes mellitus by study centers; Table S2. Pregnancy outcomes by gestational diabetes mellitus; Table S3. Adjusted ORs (95% CIs) for pregnancy outcomes by gestational diabetes mellitus, stratified by prepregnancy body mass index; Table S4. Adjusted ORs (95% CIs) for pregnancy outcomes by gestational diabetes mellitus, stratified by gestational weight gain.
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This is a preprint. It has not completed peer review.
Research
Association of Gestational Diabetes Mellitus With Adverse Pregnancy Outcomes and Its Interaction With Maternal Age in Chinese Urban Women
Xueyin Wang
Peking University First Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0003-4461-324X
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 31 Dec, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: The prevalence of gestational diabetes mellitus (GDM) has been dramatically increasing worldwide. The aims of this study were to examine associations of GDM with pregnancy outcomes in Chinese urban women, and to evaluate the interaction between GDM and other major risk factors for the risk of adverse pregnancy outcomes.
Methods: A retrospective analysis included 8,844 women who delivered live singletons at ≥28 weeks of gestation between June 2012 and March 2013 among Chinese urban women. Structured questionnaires were used to collect the information on demographic characteristics, lifestyle behavior, medical history and pregnancy outcomes. The diagnosis of GDM was made between 24 and 28 gestational weeks according to the International Association of Diabetes and Pregnancy Study Groups criteria. Logistic regression models were used to assess the association of GDM with pregnancy outcomes, and to examine the interaction between GDM and other major risk factors including maternal age, prepregnancy body mass index and gestational weight gain for the risk of pregnancy outcomes.
Results: 13.9% of women were diagnosed with GDM. We found that GDM was associated with higher risk of cesarean delivery (Odds Ratio [OR] =1.69, 95% CI [confidence interval]: 1.48-1.92), preterm birth (OR=1.32, 95% CI: 1.07-1.64), macrosomia (OR=1.69, 95% CI: 1.34-2.13) and large-for-gestational age (LGA, OR=1.43, 95% CI: 1.18-1.73) after adjustment for potential confounders. We also observed the interaction between GDM and maternal age for the risk of cesarean delivery (P for interaction = 0.025), and the prevalence of cesarean delivery was higher in women with GDM than those unaffected of GDM regardless of maternal age (age <35 years: 58.5% vs. 44.3%; age ≥35 years: 67.7% vs. 64.3%). Women aged ≥35 years and above and having GDM had a 2.10-fold increased risk of cesarean delivery compared to those who was under 35 years old and did not having GDM (OR=2.10, 95% CI: 1.48-2.93).
Conclusions: GDM was associated with increased risk of cesarean delivery, preterm birth, macrosomia and LGA in Chinese urban women, and there was the interaction between GDM and maternal age for the risk of cesarean delivery.
Figure 1
Figure 2