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

查看全文 作　　者：Geng [1,2]Song;Yumei [1,2]Wei;Juan [1,2]Juan;Rina [1,2]Su;Jianying [3]Yan;Mei [4]Xiao;Xianlan [5]Zhao;Meihua [6]Zhang;Yuyan [7]Ma;Haiwei [8]Liu;Jingxia [9]Sun;Kejia [10]Hu;Huixia [1,2]Yang 高影响力作者 机构地区：[1]Department of Obstetrics and Gynecology,Peking University First Hospital,Beijing 100034,China;[2]Beijing Key Laboratory of Maternal Fetal Medicine of Gestational Diabetes Mellitus,Beijing 100034,China;[3]Department of Obstetrics and Gynecology,Fujian Province Maternal and Child Health Hospital,Fuzhou 350005,China;[4]Department of Obstetrics and Gynecology,Maternal and Child Health Hospital of Hubei Province,Wuhan 430064,China;[5]Department of Obstetrics and Gynecology,Zhengzhou University First Affiliated Hospital,Zhengzhou 450052,China;[6]Department ofObstetrics and Gynecology,Taiyuan Maternal and Child Health Hospital,Taiyuan 030012,China;[7]Department of Obstetrics and Gynecology,Shandong University Qilu Hospital,Jinan 250063,China;[8]Department of Obstetrics and Gynecology,Hainan General Hospital,Haikou 570311,China;[9]Department of Obstetrics and Gynecology,First Affiliated Hospital of Harbin Medical University,Harbin 150007,China;[10]Department of Obstetrics and Gynecology,Beijing Shunyi District Hospital,Beijing 101312,China高影响力机构 出　　处：《Maternal-Fetal Medicine》索引2023年第5卷第1期,共7页高影响力期刊 基　　金：supported by grants from the National Program on Basic Research Project of China(2019FY101005 to Geng Song);the World Diabetes Foundation(No.WDF 10-517 and No.WDF 14-908 to Huixia Yang);Scientific Research Seed Fund of Peking University First Hospital(2018SF046 to Geng Song)。 摘　　要：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/ort-test for qualitative or quantitative variables,respectively.Associations withP 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. 关 键 词：Diabetes GESTATIONAL Without GDM history Risk factors Subsequent pregnancy.
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