Prevalence of Abnormal Glucose Values and Gestational Diabetes Mellitus Among Pregnant Women in Xi'an from 2015 to 2021

Overview

Journal BMC Pregnancy Childbirth

Publisher Biomed Central

Specialty Gynecology & Obstetrics

Date 2023 Jun 24

PMID 37355571

Authors

Gai Li Meng

Qi Wang

Ru Kang

Xiao Yue Cheng

Jun Lan Yang

Yun Xie

Affiliations

Soon will be listed here.

Abstract

Background: Pregnant women with gestational diabetes mellitus (GDM) often have an increased risk of adverse pregnancy outcomes. The purpose of this study was to explore the prevalence and characteristics of GDM in Xi'an from 2015 to 2021 since the implementation of China's "Two-Child policy" and to provide a clinical basis for the management of GDM.

Methods: We analyzed the oral glucose tolerance test (OGTT) results of 152,836 pregnant women who underwent routine prenatal examination at the Northwest Women and Children's Hospital from 2015 to 2021. Additionally, we analyzed the GDM prevalence and characteristics.

Results: The prevalence of GDM in the Xi'an urban area was 24.66% and exhibited an increasing trend annually (χ2 for trend = 43.922, p < 0.001) and with age (χ2 for trend = 2527.000, p < 0.001). Consistent with this, the proportion of pregnant women aged 18-25 and 26-30 years decreased significantly with the annual growth (χ2 for trend = 183.279, p < 0.001 and χ2 for trend = 33.192, p < 0.001, respectively). The proportion of pregnant women aged 31-35 and 36-42 years increased gradually annually (χ2 for trend = 134.436, p < 0.001and χ2 for trend = 44.403, p < 0.001, respectively). Of the pregnant women diagnosed with GDM, 71.15% (65.05-74.95%) had abnormal fasting plasma glucose (FPG) values. The highest percentage of patients had a single abnormal OGTT value (68.31%; 65.77-70.61%), followed by two (20.52%; 18.79-22.55%) and three (11.17%; 10.11-11.85%) abnormal values (FPG and 1-h and 2-h plasma glucose (PG).

Conclusion: The prevalence of GDM among pregnant women in Xi'an region was high, and it had a increasing trend over the period from 2015 to 2021. Notably, the proportion of elder pregnant women, aged 31-42 years, presented a significant rise after the implementation of the universal two-child policy. On the basis of the high incidence of GDM among elder pregnant women and the high rate of abnormal OGTT values (numbe ≥ 2) in pregnant women diagnosed with GDM, the management of GDM should be intensified, and relevant departments should pay more attention to pregnant women of advanced age.

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References

Sirico A, DellAquila M, Tartaglione L, Moresi S, Fari G, Pitocco D . PTH-rP and PTH-R1 Expression in Placentas from Pregnancies Complicated by Gestational Diabetes: New Insights into the Pathophysiology of Hyperglycemia in Pregnancy. Diagnostics (Basel). 2021; 11(8). PMC: 8394866. DOI: 10.3390/diagnostics11081356. View

Oglak S, Yavuz A, Olmez F, Gedik Ozkose Z, Suzen Caypinar S . The reduced serum concentrations of -arrestin-1 and -arrestin-2 in pregnancies complicated with gestational diabetes mellitus. J Matern Fetal Neonatal Med. 2022; 35(25):10017-10024. DOI: 10.1080/14767058.2022.2083495. View

Sweeting A, Wong J, Appelblom H, Ross G, Kouru H, Williams P . A Novel Early Pregnancy Risk Prediction Model for Gestational Diabetes Mellitus. Fetal Diagn Ther. 2018; 45(2):76-84. DOI: 10.1159/000486853. View

Wang H, Li N, Chivese T, Werfalli M, Sun H, Yuen L . IDF Diabetes Atlas: Estimation of Global and Regional Gestational Diabetes Mellitus Prevalence for 2021 by International Association of Diabetes in Pregnancy Study Group's Criteria. Diabetes Res Clin Pract. 2021; 183:109050. DOI: 10.1016/j.diabres.2021.109050. View

Sirico A, Rossi E, Degennaro V, Arena V, Rizzi A, Tartaglione L . Placental diabesity: placental VEGF and CD31 expression according to pregestational BMI and gestational weight gain in women with gestational diabetes. Arch Gynecol Obstet. 2022; 307(6):1823-1831. DOI: 10.1007/s00404-022-06673-3. View

. 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2022. Diabetes Care. 2021; 45(Suppl 1):S17-S38. DOI: 10.2337/dc22-S002. View

Xu X, Liu Y, Liu D, Li X, Rao Y, Sharma M . Prevalence and Determinants of Gestational Diabetes Mellitus: A Cross-Sectional Study in China. Int J Environ Res Public Health. 2018; 14(12). PMC: 5750950. DOI: 10.3390/ijerph14121532. View

Sweeting A, Wong J, Murphy H, Ross G . A Clinical Update on Gestational Diabetes Mellitus. Endocr Rev. 2022; 43(5):763-793. PMC: 9512153. DOI: 10.1210/endrev/bnac003. View

Sirico A, Sarno L, Zullo F, Martinelli P, Maruotti G . Pregestational diabetes and fetal heart rate in the first trimester of pregnancy. Eur J Obstet Gynecol Reprod Biol. 2018; 232:30-32. DOI: 10.1016/j.ejogrb.2018.11.003. View

10.

Zhu H, Zhao Z, Xu J, Chen Y, Zhu Q, Zhou L . The prevalence of gestational diabetes mellitus before and after the implementation of the universal two-child policy in China. Front Endocrinol (Lausanne). 2022; 13:960877. PMC: 9433653. DOI: 10.3389/fendo.2022.960877. View

11.

Wei Y, Xu Q, Yang H, Yang Y, Wang L, Chen H . Preconception diabetes mellitus and adverse pregnancy outcomes in over 6.4 million women: A population-based cohort study in China. PLoS Med. 2019; 16(10):e1002926. PMC: 6771981. DOI: 10.1371/journal.pmed.1002926. View

12.

Ding T, Xiang J, Luo B, Hu J . Relationship between the IADPSG-criteria-defined abnormal glucose values and adverse pregnancy outcomes among women having gestational diabetes mellitus: A retrospective cohort study. Medicine (Baltimore). 2018; 97(43):e12920. PMC: 6221640. DOI: 10.1097/MD.0000000000012920. View

13.

He Z, Xie H, Liang S, Tang Y, Ding W, Wu Y . Influence of different diagnostic criteria on gestational diabetes mellitus incidence and medical expenditures in China. J Diabetes Investig. 2019; 10(5):1347-1357. PMC: 6717806. DOI: 10.1111/jdi.13008. View

14.

Gao C, Sun X, Lu L, Liu F, Yuan J . Prevalence of gestational diabetes mellitus in mainland China: A systematic review and meta-analysis. J Diabetes Investig. 2018; 10(1):154-162. PMC: 6319492. DOI: 10.1111/jdi.12854. View

15.

Mak J, Lee A, Pham N, Pan X, Tang L, Binns C . Gestational diabetes incidence and delivery outcomes in Western China: A prospective cohort study. Birth. 2018; 46(1):166-172. DOI: 10.1111/birt.12397. View

16.

Halban P, Polonsky K, Bowden D, Hawkins M, Ling C, Mather K . β-cell failure in type 2 diabetes: postulated mechanisms and prospects for prevention and treatment. J Clin Endocrinol Metab. 2014; 99(6):1983-92. PMC: 5393482. DOI: 10.1210/jc.2014-1425. View

17.

Bogdanet D, OShea P, Lyons C, Shafat A, Dunne F . The Oral Glucose Tolerance Test-Is It Time for a Change?-A Literature Review with an Emphasis on Pregnancy. J Clin Med. 2020; 9(11). PMC: 7693369. DOI: 10.3390/jcm9113451. View

18.

Di Filippo D, Henry A, Bell C, Haynes S, Chang M, Darling J . A new continuous glucose monitor for the diagnosis of gestational diabetes mellitus: a pilot study. BMC Pregnancy Childbirth. 2023; 23(1):186. PMC: 10023314. DOI: 10.1186/s12884-023-05496-7. View

19.

Yuan Y, Zhu Q, Yao X, Shi Z, Wen J . Maternal circulating metabolic biomarkers and their prediction performance for gestational diabetes mellitus related macrosomia. BMC Pregnancy Childbirth. 2023; 23(1):113. PMC: 9926775. DOI: 10.1186/s12884-023-05440-9. View

20.

Metzger B, Gabbe S, Persson B, Buchanan T, Catalano P, Damm P . International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care. 2010; 33(3):676-82. PMC: 2827530. DOI: 10.2337/dc09-1848. View