Incidence of gestational diabetes mellitus and risk factors in Zhoushan Islands, Zhejiang

ObjectiveTo understand the incidence of gestational diabetes mellitus (GDM) in pregnant women in Zhoushan, Zhejiang province, and identify its influencing factors.

MethodsThe data of all the pregnant women underwent GDM screening in Zhoushan Maternal and Child Care Center from January 2014 to June 2018 were retrospectively analyzed in this study. Logistic regression models were used for the identification of the risk factors for GDM and GDM subtypes.

ResultsA total of 10 802 pregnant women received GDM screening, the oral glucose tolerance test indicated that 1 489 pregnant women had GDM (13.78%). The proportions of different GDM subtypes (A, B and C) were 21.49%, 66.15% and 12.36%, respectively, in 1 489 GDM cases. The multivariate logistic regression analysis showed that older age, higher BMI during early pregnancy, higher blood glucose level during early pregnancy, higher heart rate during early pregnancy, higher albumin level during early pregnancy, screening in winter/spring and being primipara were the risk factors for GDM, while educational level was not associated with the risk for GDM. The multiple logistic regression analysis for different GDM subtype showed that higher BMI, higher blood glucose level during early pregnancy and screening in winter/spring were associated with increased risks for GDM subtype A. Older age, higher blood glucose level, higher heart rate and higher albumin level during early pregnancy, screening in winter/spring and higher educational level were associated with increased risk for GDM subtype B, while being multipara decreased the risk for GDM subtype B. Older age, higher BMI, higher heart rate and higher blood glucose level during early pregnancy, and screening in winter/spring were associated with increased risk for GDM subtype C, while higher educational level and being multipara decreased the risk for GDM subtype C.

ConclusionThe incidence of GDM was high in Zhoushan. Older age, higher BMI, higher blood glucose level, higher heart rate and high albumin level during early pregnancy, screening in winter/spring increased the risk for GDM, respectively. It is important to avoid pregnancy at older age and control pre-pregnancy BMI and blood glucose level during early pregnancy to reduce the risk for GDM and improve the health of both mothers and infants.