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Risk Factors for Gestational Diabetes Mellitus in the Population of Western China

Shengtao Zhou, Ming Wang and Li Zhang*

Objective: We aim to explore the risk factors of gestational diabetes mellitus (GDM) in the population of western China.

Methods: We conducted a prospective cohort study which recruited 908 pregnant females, who were registered in West China Second Hospital of Sichuan University from January 1st to December 31st in 2011. Self-designed questionnaires were used to collect related clinical data. The pregnancies were followed up until 42 days postpartum. We analyzed the data with Mann-Whitney U test, Chi-Square Test, logistic regression analysis and rank correlation coefficient analysis.

Results: Univariate analysis of the data showed that maternal age, leg-to-height percentage, body mass index (BMI) before pregnancy, delivery history, dietary history, family histories of diabetes mellitus (DM), hepatitis B surface antigen (HBsAg) carrier status, serum triglyceride and hemoglobin A1c (HbA1c) levels at first trimester are closely correlated with the incidence of GDM. In addition, logistic regression analysis showed that age (OR=1.081, 95% CI 1.027~1.138), unbalanced diet (OR=3.329, 95% CI 2.167~5.116), fruit intake (OR=2.005, 95% CI 1.447~2.780), fondness for sweet food (OR=1.604, 95% CI 1.129~2.280), pre-pregnancy BMI (OR=1.095, 95% CI 1.008~1.190), gravidity (OR=1.263, 95% CI 1.107~1.442), HBsAg carrier status (OR=3.173, 95% CI 1.387~7.260), family histories of DM (OR=1.798, 95% CI 1.063~3.041), high serum triglyceride level (OR=1.315, 95% CI 1.117~1.548) and HbA1c (OR=10.272, 95% CI 4.719~22.363) are correlated with GDM. Furthermore, bivariate correlation analysis showed that age and pre-pregnancy BMI are positively correlated with the fasting, 1-hour, and 2- hour results of 75 g oral glucose tolerance test (OGTT) while leg-to-height percentage is negatively correlated with the 2-h result of 75 g OGTT.

Conclusion: Advanced maternal age, multigravidity, high pre-pregnancy BMI, low leg-to-height percentage, HBsAg-positive status, matrilineal history of DM, unbalanced diet, high fruit intake, high sweet food intake, and high serum triglyceride and HbA1c levels are risk factors for GDM in western Chinese population.