Introduction
Materials and methods
Study design and participants
Data source
GDM diagnosis and glycemic control
Maternal and neonatal outcomes
Statistical analysis
Results
Characteristics of study population
(A) | |||
---|---|---|---|
Maternal characteristics | Non-GDM (n = 2372) | GDM (n = 897) | P value |
Age (SD), year | 30.31 ± 3.81 | 31.40 ± 3.62 | <0.001 |
< 35, N (%) | 2061 (86.9) | 735 (81.9) | <0.001 |
≥ 35, N (%) | 311 (13.2) | 162 (17.9) | |
Chorionicity | |||
MCDA, N (%) | 343 (14.5) | 116 (12.9) | 0.284 |
DCDA, N (%) | 2029 (85.5) | 781 (87.1) | |
Pre-pregnancy (SD), (kg/m2) | 21.21 ± 2.67 | 22.39 ± 3.09 | <0.001 |
Underweight, N (%) | 352 (14.8) | 68 (7.6) | <0.001 |
Normal weight, N (%) | 1662 (70.1) | 593 (66.1) | 0.029 |
Overweight, N (%) | 325 (13.7) | 196 (21.9) | <0.001 |
Obesity, N (%) | 33 (1.4) | 40 (4.4) | <0.001 |
Gestational gain (SD), (kg/m2) | 6.89 ± 2.12 | 6.44 ± 2.40 | <0.001 |
Excessive gestational weight gain, N (%) | 655 (27.6) | 166 (18.5) | <0.001 |
Conception by ART, N (%) | 1850 (78.0) | 740 (82.5) | 0.005 |
Chronic hypertension, N (%) | 64 (2.7) | 54 (6.0) | <0.001 |
(B) | ||||
---|---|---|---|---|
Maternal outcomes | Non-GDM (n = 2372) | GDM (n = 897) | P value | ORa (95% CI) |
Preterm birth <34 weeks, N (%) | 306 (12.9) | 127 (14.2) | 0.189 | 0.851 (0.668, 1.083) |
Preterm birth <37 weeks, N (%) | 1306 (55.1) | 520 (58.0) | 0.534 | 0.926 (0.728, 1.179) |
Hypothyroidism, N (%) | 240 (10.1) | 94 (10.5) | 0.969 | 1.005 (0.777, 1.300) |
Preeclampsia, N (%) | 400 (16.9) | 164 (18.3) | 0.699 | 1.041 (0.849, 1.277) |
PROM, N (%) | 520 (21.9) | 178 (19.8) | 0.406 | 0.921 (0.759, 1.118) |
Placental abruption, N (%) | 35 (1.5) | 12 (1.3) | 0.875 | 0.948 (0.486, 1.848) |
Placenta previa, N (%) | 108 (4.6) | 37 (4.1) | 0.426 | 0.854 (0.579, 1.260) |
Severe postpartum hemorrhage, N (%) | 112 (4.7) | 44 (4.9) | 0.99 | 1.002 (0.697, 1.441) |
Oligohydramnios, N (%) | 126 (5.3) | 43 (4.8) | 0.604 | 0.909 (0.634, 1.304) |
(C) | |||
---|---|---|---|
Maternal characteristics | Non-insulin-treated GDM (n = 825) | Insulin-treated GDM (n = 72) | P value |
Age (SD), year | 31.31 ± 3.57 | 32.36 ± 4.04 | 0.018 |
< 35, N (%) | 684 (82.9) | 51 (70.8) | 0.011 |
≥ 35, N (%) | 141 (17.1) | 21 (29.2) | |
Chorionicity | |||
MCDA, N (%) | 106 (12.8) | 10 (13.9) | 0.801 |
DCDA, N (%) | 719 (87.2) | 62 (86.1) | |
Pre-pregnancy (SD), (kg/m2) | 22.23 ± 3.06 | 24.14 ± 2.97 | 0.013 |
Underweight, N (%) | 67 (8.1) | 1 (1.4) | 0.160a |
Normal weight, N (%) | 558 (67.6) | 35 (48.6) | <0.001 |
Overweight, N (%) | 169 (20.5) | 27 (37.5) | 0.001 |
Obesity, N (%) | 31 (3.8) | 9 (12.5) | <0.001 |
Gestational gain (SD), (kg/m2) | 6.49 ± 2.39 | 5.81 ± 2.29 | <0.001 |
Excessive gestational weight gain, N (%) | 155 (18.8) | 11 (15.2) | 0.462 |
Conception by ART, N (%) | 676 (81.9) | 64 (88.9) | 0.137 |
Chronic hypertension, N (%) | 48 (5.8) | 6 (8.3) | 0.390 |
(D) | ||||
---|---|---|---|---|
Maternal outcomes | Non insulin treated GDM (n = 825) | Insulin treated GDM (n = 72) | P value | ORa (95% CI) |
Preterm birth <34 weeks, N (%) | 113 (13.7) | 14 (19.4) | 0.053 | 1.750 (0.994, 3.080) |
Preterm birth <37 weeks, N (%) | 469 (56.8) | 51 (70.8) | 0.045 | 2.096 (1.017, 4.321) |
Hypothyroidism, N (%) | 82 (9.9) | 12 (16.7) | 0.323 | 1.427 (0.704, 2.893) |
Preeclampsia, N (%) | 154 (18.7) | 10 (13.9) | 0.227 | 0.649 (0.321, 1.309) |
PROM, N (%) | 166 (20.1) | 12 (16.7) | 0.680 | 0.871 (0.453, 1.677) |
Placental abruption, N (%) | 12 (1.5) | 0 (0.0) | - | - |
Placenta previa, N (%) | 32 (3.9) | 5 (6.9) | 0.323 | 1.673 (0.603, 4.640) |
Severe postpartum hemorrhage, N (%) | 112 (4.7) | 44 (4.9) | 0.183 | 0.255 (0.034, 1.905) |
Oligohydramnios, N (%) | 126 (5.3) | 43 (4.8) | 0.443 | 0.564 (0.131, 2.436) |
Risk factors | GDM vs Non-GDM | Insulin-treated GDM vs. Non-insulin-treated GDM | ||
---|---|---|---|---|
P value | OR (95% CI) | P value | OR (95% CI) | |
Maternal age ≥ 35 years | 0.014 | 1.307 (1.055–1.618) | 0.027 | 1.881 (1.073–3.295) |
Underweight | <0.001 | 0.559 (0.423–0.737) | 0.142 | 0.222 (0.030–1.657) |
Overweight | <0.001 | 1.611 (1.315–1.973) | <0.001 | 2.450 (1.422–4.223) |
Obesity | <0.001 | 2.951 (1.828–4.762) | <0.001 | 4.056 (1.728–9.522) |
DCDA | 0.446 | 0.898 (0.680–1.185) | 0.095 | 0.492 (0.214–1.131) |
Conception by ART | 0.113 | 1.219 (0.955–1.556) | 0.162 | 1.886 (0.775–4.585) |
Chronic hypertension | <0.001 | 1.896 (1.290–2.785) | 0.808 | 0.890 (0.348–2.278) |
Hypothyroidism | 0.996 | 1.003 (0.775–1.299) | 0.348 | 1.407 (0.690–2.872) |
Preeclampsia | 0.501 | 1.076 (0.876–1.322) | 0.192 | 0.621 (0.303–1.271) |
(A) | ||||
---|---|---|---|---|
Non-GDM (n = 4744) | GDM (n = 1794) | P value | OR (95% CI) | |
Gestational age (SD), week | 35.58 ± 1.94 | 35.48 ± 1.87 | 0.051 | - |
Birthweight (SD), g | 2385.63 ± 444.77 | 2400.79 ± 395.43 | 0.205 | - |
Male fetus, N (%) | 2344 (49.4) | 891 (49.7) | 0.854 | 1.010 (0.906, 1.126) |
SGA, N (%) | 610 (12.9) | 201 (11.2) | 0.070 | 0.855 (0.722, 1.013) |
LGA, N (%) | 111 (2.3) | 49 (2.7) | 0.361 | 1.172 (0.834, 1.648) |
Birthweight <1500 g, N (%) | 212 (4.5) | 55 (3.1) | 0.011 | 0.676 (0.500, 0.914) |
Birthweight <2500 g, N (%) | 2607 (55.0) | 994 (55.4) | 0.742 | 1.018 (0.913, 1.136) |
1-min Apgar score <7, N (%) | 13 (0.3) | 9 (0.5) | 0.156 | 1.835 (0.783, 4.300) |
5-min Apgar score <7, N (%) | 3 (0.1) | 1 (0.1) | 1.000a | 0.881 (0.092, 8.479) |
Neonatal intensive care unit admission, N (%) | 127 (2.7) | 59 (3.3) | 0.184 | 1.236 (0.903, 1.692) |
EUGR, N (%) | 101 (2.1) | 58 (3.2) | 0.010 | 1.536 (1.107, 2.131) |
Neonatal hypoglycemia, N (%) | 57 (1.2) | 32 (1.8) | 0.070 | 1.493 (0.965, 2.310) |
(B) | ||||
---|---|---|---|---|
Non-insulin-treated GDM (n = 1650) | Insulin-treated GDM (n = 144) | P value | OR (95% CI) | |
Gestational age (SD), week | 35.51 ± 1.88 | 35.13 ± 1.73 | 0.030 | - |
Birthweight (SD), g | 2396.99 ± 422.56 | 2358.47 ± 414.62 | 0.294 | - |
Male fetus, N (%) | 816 (49.5) | 75 (52.1) | 0.545 | 1.111 (0.790, 1.562) |
SGA, N (%) | 190 (11.5) | 7 (4.9) | 0.014 | 0.393 (0.181, 0.852) |
LGA, N (%) | 45 (2.7) | 5 (3.5) | 0.602 | 1.283 (0.501, 3.285) |
Birthweight <1500 g, N (%) | 46 (2.8) | 3 (2.1) | 0.619a | 0.742 (0.228, 2.416) |
Birthweight <2500 g, N (%) | 912 (55.3) | 82 (56.9) | 0.699 | 1.070 (0.759, 1.509) |
1-min Apgar score <7, N (%) | 8 (0.5) | 1 (0.7) | 1.000a | 1.435 (0.178, 11.557) |
5-min Apgar score <7, N (%) | 1 (0.1) | 0 (0.0) | 1.000a | - |
Neonatal intensive care unit admission, N (%) | 53 (3.2) | 6 (4.2) | 0.538 | 1.310 (0.553, 3.102) |
EUGR, N (%) | 46 (2.8) | 12 (8.3) | <0.001 | 3.170 (1.639, 6.131) |
Neonatal hypoglycemia, N (%) | 31 (1.9) | 1 (0.7) | 0.483a | 0.365 (0.049, 2.695) |