Zhongguo quanke yixue (Sep 2023)
Prevalence and Epidemiology of Gestational Diabetes Mellitus from 2014 to 2021 in Hebei Province
Abstract
Background Gestational diabetes mellitus (GDM) is one of the common pregnancy complications, which not only increases the maternal risk of short-term and long-term complications such as maternal preeclampsia and type 2 diabetes, but also the incidence rates of fetal malformation, macrosomia, etc. GDM has become a public health and social issue which can not be ignored. Objective To investigate the prevalence and epidemiological characteristics of GDM in Hebei Province. Methods Using a cross-sectional study method, the relevant data of inpatient deliveries from maternal monitoring information system involving 22 monitoring hospitals provided by Hebei Center for Maternal and Child Health were collected, including maternal delivery hospital, maternal age, marital status, education level, number of pregnancies, deliveries and prenatal examinations, season of delivery, complications during this pregnancy, mode of delivery, gender and body mass of newborn, and occupancy at NICU. Results A total of 366 212 pregnant women were enrolled in this study, 25 995 of whom were diagnosed with GDM, with the incidence rate of 7.1%. The prevalence of maternal GDM showed an upward trend year after year from 2014 to 2021 (χ2trend=6 921.4, P<0.001). The incidence rate of GDM in advanced maternal aged (χ2trend=779.0, P<0.001) and urban maternity (χ2trend=5 057.1, P<0.001), showing an upward trend year after year. And there were statistical significant differences in the prevalence of GDM among different regions of Hebei Province (χ2=16 919.785, P<0.001). The prevalence of maternal GDM in urban〔10.6% (19 200/180 369) 〕was higher than rural〔3.7% (6 795/185 843) 〕 from 2014 to 2021 in Hebei Province (χ2=6 872.800, P<0.001). There were significant differences in prevalence of maternal GDM among primary〔0.7% (34/4 731) 〕, secondary〔3.7% (6 733/180 923) 〕, and tertiary hospitals〔10.6% (19 228/180 558) 〕from 2014 to 2021 in Hebei Province (χ2=6 872.800, P<0.001). There were statistically significant differences in the prevalence of maternal GDM among women of different maternal age, educational level, number of pregnancies, deliveries and prenatal examinations (P<0.05); The prevalence of GDM in women aged 18-<35, 35-<40, and ≥40 years was higher than women aged <18 years, and the prevalence of GDM in women aged 35-<40, and ≥40 years was higher than women aged 18-<35 years; The prevalence of GDM of women with university or higher education level was higher than women with high school, junior high school, primary school and illiteracy; The prevalence of GDM of women with multiple pregnancies was higher than women with 1 pregnancy; The prevalence of GDM of multipara was higher than unipara; The prevalence of GDM of women ≥8 prenatal examinations was higher than women of <8 prenatal examinations. There were statistically significant differences in the prevalence of maternal GDM among women with deliver season of spring (March to May) 〔7.27% (6 583/90 546) 〕, summer (June to August) 〔6.95% (6 360/91 521) 〕, autumn (September to November) 〔7.08% (6 632/93 729) 〕 and winter (December to February) 〔7.10% (6 420/90 416) 〕 from 2014 to 2021 in Hebei Province (χ2=9.350, P<0.05). The differences in maternal GDM were statistically significant when comparing the combination of gestational hypertension, anemia and uterine atony, delivery modes, and deliver of macrosomia (P<0.05) . Conclusion The prevalence of GDM in Hebei Province was 7.1% from 2014 to 2021, showing an upward trend from 2014-2021. And the prevalence of GDM is increased in women with advanced age, living in urban, with high education level, multiple pregnancies, and multipara.
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