Background
Methods
Study design and population
Shanghai birth cohort
GUSTO cohort
Subject follow up and assessment of maternal blood glucose concentrations
Statistical analysis
Results
Comparison of demographic variables between SBC and GUSTO cohort
Characteristics | SBC (n = 734) | GUSTO (n = 677) | P-value |
---|---|---|---|
Maternal age | 29.8 ± 3.7 | 32.1 ± 4.8 | < 0.001 |
Plasma glucose fasting, mmol/L | 4.4 ± 0.4 | 4.3 ± 0.4 | < 0.001 |
Plasma glucose 1 h, mmol/L | 7.6 ± 1.6 | NA | NA |
Plasma glucose 2 h, mmol/L | 6.5 ± 1.4 | 6.6 ± 1.4 | 0.143 |
Pre-pregnancy BMI, kg/m2 | 21.5 ± 3.2 | 21.6 ± 3.4 | 0.637 |
BMI at early pregnancy, kg/m2 | 22.5 ± 3.4 | 22.4 ± 3.7 | 0.320 |
Pre-pregnancy weight, kg | 56.6 ± 8.7 | 54.5 ± 9.5 | < 0.001 |
Weight at early pregnancy, kg | 59.1 ± 9.4 | 56.8 ± 10.3 | < 0.001 |
GWG at early pregnancy, kg | 2.5 ± 3.2 | 1.9 ± 2.4 | 0.001 |
GWG velocity at early pregnancy, kg/week | 0.2 ± 0.2 | 0.2 ± 0.2 | 0.911 |
Height, cm | 162.2 ± 4.6 | 159.1 ± 5.6 | < 0.001 |
Pre-pregnancy BMI (kg/m2) | 0.369 | ||
<18.5(underweight) | 109(14.9 %) | 82(13.5 %) | |
≥ to < 23 (normal) | 436(59.4 %) | 365(60.2 %) | |
≥ to < 27.5 (overweight) | 154(21.0 %) | 118(19.5 %) | |
≥ (obese) | 35(4.8 %) | 41(6.8 %) | |
GWG in early pregnancy (z score) | 0.985 | ||
<-1 | 82(11.2 %) | 68(11.5 %) | |
-1 to 1 | 552(75.6 %) | 446(75.2 %) | |
> 1 | 96(13.2 %) | 79(13.3 %) | |
Alcohol consumption during pregnancy | 2(0.3 %) | 21(3.3 %) | < 0.001 |
Family history of diabetes | 62(9.2 %) | 165(24.4 %) | < 0.001 |
Family history of hypertension | 225(32.7 %) | 279(41.2 %) | 0.001 |
Current or ever smoker | 22(3.0 %) | 61(9.4 %) | < 0.001 |
History of GDM in previous pregnancy | 3(0.4 %) | 22(3.2 %) | < 0.001 |
Personal history of chronic hypertension | 1(0.1 %) | 8(1.2 %) | 0.017 |
Parous | 84(11.5 %) | 316(48.8 %) | < 0.001 |
Gestational age at delivery, week | 39.0 ± 1.5 | 38.8 ± 1.4 | 0.002 |
Male fetus | 349(49.7 %) | 340(52.6 %) | 0.298 |
Citizenship status | NA | NA | |
Singapore Citizen born in Singapore | 379(56.0 %) | ||
Converted Citizen or permanent resident | 298(44.0 %) |
Comparison of risk factors of GDM between SBC and GUSTO cohort
1999 WHO criteria
GDM | Shanghai Birth cohort Unadjusted | GUSTO Birth Cohort Unadjusted | Shanghai Birth cohort Adjusted | GUSTO Birth Cohort Adjusted | P-value* | ||||
---|---|---|---|---|---|---|---|---|---|
OR (95 % CI) | P-value | OR (95 % CI) | P-value | OR (95 % CI) | P- value | OR (95 % CI) | P- value | ||
Maternal age | 1.08(1.03–1.14) | 0.003 | 1.09(1.04–1.14) | < 0.001 | 1.1(1.0-1.2) | 0.020 | 1.09(1.03–1.14) | 0.001 | 1.000 |
Pre-pregnancy BMI | 1.08(1.03–1.15) | 0.005 | 1.11(1.05–1.17) | < 0.001 | 1.1(1.0-1.2) | 0.028 | 1.1(1.0-1.2) | 0.002 | 1.000 |
GWG at early pregnancy (z score) | |||||||||
<-1 | 1.0 | 1.0 | 1.0 | 1.0 | |||||
-1 to 1 | 0.96(0.52–1.78) | 0.894 | 1.6(0.8–3.2) | 0.208 | 1.0(0.5–2.2) | 0.955 | 1.7(0.8–3.5) | 0.175 | 0.189 |
> 1 | 0.97(0.44–2.13) | 0.942 | 1.8(0.8–4.2) | 0.173 | 0.88(0.34–2.25) | 0.786 | 1.7(0.7-4.0) | 0.258 | 0.211 |
Alcohol consumption | 5.1(0.3–82.0) | 0.251 | 0.67(0.19–2.32) | 0.526 | 8.8(0.5-144.8) | 0.128 | 0.73(0.20–2.64) | 0.632 | < 0.001 |
Family history of diabetes | 1.6(0.8-3.0) | 0.165 | 1.0(0.6–1.6) | 0.981 | 1.0(0.5–2.1) | 0.996 | 0.86(0.52–1.43) | 0.566 | 0.755 |
Family history of hypertension | 1.6(1.0-2.4) | 0.032 | 0.78(0.53–1.16) | 0.223 | 1.5(0.9–2.5) | 0.092 | 0.67(0.43–1.04) | 0.076 | 0.016 |
Current or ever smoker | 1.1(0.4–3.4) | 0.842 | 0.79(0.39–1.61) | 0.515 | 1.6(0.4-6.0) | 0.509 | 1.1(0.5–2.3) | 0.858 | 0.528 |
Parous | 1.0(0.5–1.8) | 1.000 | 1.2(0.8–1.7) | 0.470 | 0.74(0.34–1.61) | 0.443 | 0.97(0.64–1.49) | 0.893 | 0.610 |
Male fetus | 1.1(0.7–1.7) | 0.633 | 1.1(0.7–1.6) | 0.781 | 1.1(0.7–1.7) | 0.801 | 1.1(0.7–1.6) | 0.744 | 1.000 |
GDM | Shanghai Birth cohort Unadjusted | GUSTO Birth Cohort Unadjusted | Shanghai Birth cohort Adjusted | GUSTO Birth Cohort Adjusted | P-value* | ||||
---|---|---|---|---|---|---|---|---|---|
OR (95 % CI) | P-value | OR (95 % CI) | P-value | OR (95 % CI) | P-value | OR (95 % CI) | P-value | ||
Maternal age | 1.08(1.03–1.14) | 0.003 | 1.09(1.04–1.14) | < 0.001 | 1.1(1.0-1.2) | 0.014 | 1.08(1.03–1.13) | 0.003 | 1.000 |
GWG at early pregnancy (z score) | 0.86(0.70–1.05) | 0.133 | 1.2(1.0-1.5) | 0.085 | 0.69(0.44–1.08) | 0.106 | 1.2(0.8–1.7) | 0.444 | 0.088 |
Pre-pregnancy BMI | |||||||||
< 18.5 | 0.72(0.37–1.39) | 0.324 | 0.93(0.49–1.80) | 0.838 | 0.85(0.38–1.90) | 0.687 | 1.0(0.5–2.1) | 0.911 | 0.785 |
≥ 18.5 to < 23 | 1.0 | 1.0 | 1.0 | 1.0 | |||||
≥ 23 to < 27.5 | 1.8(1.2–2.9) | 0.009 | 1.9(1.1-3.0) | 0.014 | 2.3(1.3–3.9) | 0.004 | 1.7(1.0-2.9) | 0.047 | 0.124 |
≥ 27.5 | 2.0(0.9–4.5) | 0.088 | 3.7(1.8–7.3) | < 0.001 | 1.9(0.7–5.5) | 0.239 | 3.7(1.8–7.8) | < 0.001 | 0.005 |
Alcohol consumption | 5.1(0.3–82.0) | 0.251 | 0.67(0.19–2.32) | 0.526 | 8.7(0.5-144.1) | 0.130 | 0.75(0.21–2.69) | 0.656 | < 0.001 |
Family history of diabetes | 1.6(0.8-3.0) | 0.165 | 1.0(0.6–1.6) | 0.981 | 0.99(0.48–2.04) | 0.967 | 0.84(0.50–1.41) | 0.512 | 0.717 |
Family history of hypertension | 1.6(1.0-2.4) | 0.032 | 0.78(0.53–1.16) | 0.223 | 1.5(0.9–2.5) | 0.100 | 0.69(0.43–1.08) | 0.103 | 0.021 |
Current or ever smoker | 1.1(0.4–3.4) | 0.842 | 0.79(0.39–1.61) | 0.515 | 1.8(0.4-7.0) | 0.421 | 1.1(0.5–2.3) | 0.880 | 0.398 |
Parous | 1.0(0.5–1.8) | 1.000 | 1.2(0.8–1.7) | 0.470 | 0.68(0.31–1.50) | 0.338 | 1.0(0.7–1.6) | 0.880 | 0.481 |
Male fetus | 1.1(0.7–1.7) | 0.633 | 1.1(0.7–1.6) | 0.781 | 1.1(0.7–1.7) | 0.783 | 1.0(0.7–1.6) | 0.868 | 0.747 |
IADPSG criteria
GDM | Shanghai Birth cohort Unadjusted | GUSTO Birth Cohort Unadjusted | Shanghai Birth cohort Adjusted | GUSTO Birth Cohort Adjusted | P-value* | ||||
---|---|---|---|---|---|---|---|---|---|
OR (95 % CI) | P-value | OR (95 % CI) | P-value | OR (95 % CI) | P- value | OR (95 % CI) | P- value | ||
Maternal age | 1.1(1.0-1.2) | 0.002 | 1.08(1.03–1.14) | 0.004 | 1.1(1.0-1.2) | 0.046 | 1.06(1.00-1.13) | 0.064 | 1.000 |
Pre-pregnancy BMI | 1.14(1.07–1.21) | < 0.001 | 1.13(1.06–1.21) | < 0.001 | 1.14(1.05–1.23) | 0.001 | 1.1(1.0-1.2) | 0.006 | 1.000 |
GWG at early pregnancy (z score) | |||||||||
<-1 | 1.0 | 1.0 | 1.0 | 1.0 | |||||
-1 to 1 | 1.0(0.5-2.0) | 0.998 | 1.2(0.5–2.8) | 0.662 | 1.4(0.6–3.5) | 0.403 | 1.2(0.5–2.8) | 0.727 | 0.750 |
> 1 | 1.6(0.7–3.6) | 0.260 | 1.4(0.5–3.8) | 0.529 | 2.1(0.8–5.6) | 0.159 | 1.3(0.5–3.8) | 0.616 | 0.265 |
Alcohol consumption | 5.8(0.4–93.9) | 0.214 | 0.85(0.19–3.72) | 0.824 | 12.0(0.7–198.0) | 0.083 | 0.99(0.22–4.55) | 0.988 | < 0.001 |
Family history of diabetes | 2.3(1.3–4.3) | 0.008 | 1.3(0.7–2.2) | 0.388 | 1.8(0.9–3.6) | 0.089 | 0.67(0.35–1.30) | 0.240 | 0.020 |
Family history of hypertension | 1.5(1.0-2.3) | 0.077 | 1.1(0.7–1.8) | 0.649 | 1.4(0.8–2.3) | 0.262 | 0.88(0.51–1.54) | 0.661 | 0.182 |
Current or ever smoker | 0.94(0.27–3.25) | 0.928 | 0.70(0.27–1.80) | 0.456 | 1.6(0.4–6.3) | 0.507 | 0.87(0.31–2.42) | 0.783 | 0.405 |
Parous | 1.2(0.7–2.3) | 0.519 | 1.3(0.8–2.2) | 0.225 | 0.75(0.33–1.72) | 0.502 | 0.90(0.52–1.58) | 0.717 | 0.768 |
History of GDM in previous pregnancy | 12.2(1.1-135.3) | 0.042 | 8.3(3.3–20.7) | < 0.001 | 2.5(0.2–42.7) | 0.520 | 7.7(2.6–22.4) | < 0.001 | < 0.001 |
Male fetus | 0.97(0.63–1.49) | 0.873 | 1.0(0.6–1.6) | 0.988 | 1.0(0.6–1.6) | 0.862 | 0.83(0.49–1.41) | 0.496 | 0.644 |
GDM | Shanghai Birth cohort Unadjusted | GUSTO Birth Cohort Unadjusted | Shanghai Birth cohort Adjusted | GUSTO Birth Cohort Adjusted | P-value* | ||||
---|---|---|---|---|---|---|---|---|---|
OR (95 % CI) | P-value | OR (95 % CI) | P-value | OR (95 % CI) | P-value | OR (95 % CI) | P-value | ||
Maternal age | 1.1(1.0-1.2) | 0.002 | 1.08(1.03–1.14) | 0.004 | 1.1(1.0-1.2) | 0.030 | 1.06(0.99–1.12) | 0.099 | 1.000 |
GWG at early pregnancy (z score) | 1.0(0.8–1.3) | 0.690 | 1.1(0.9–1.5) | 0.277 | 1.1(0.7–1.7) | 0.722 | 1.1(0.7–1.8) | 0.611 | 1.000 |
Pre-pregnancy BMI | |||||||||
< 18.5 | 0.82(0.40–1.67) | 0.579 | 0.58(0.22–1.53) | 0.274 | 1.0(0.4–2.3) | 0.972 | 0.69(0.25–1.89) | 0.471 | 0.650 |
≥ 18.5 to < 23 | 1.0 | 1.0 | 1.0 | 1.0 | |||||
≥ 23 to < 27.5 | 2.5(1.5-4.0) | < 0.001 | 1.5(0.8–2.8) | 0.190 | 2.5(1.4–4.4) | 0.002 | 1.3(0.7–2.6) | 0.415 | 0.007 |
≥ 27.5 | 3.7(1.7-8.0) | 0.001 | 4.3(2.0-9.1) | < 0.001 | 3.6(1.3–9.6) | 0.011 | 3.8(1.7–8.8) | 0.001 | 0.762 |
Alcohol consumption | 5.8(0.4–93.9) | 0.214 | 0.85(0.19–3.72) | 0.824 | 11.8(0.7-196.4) | 0.086 | 1.1(0.2–4.9) | 0.939 | < 0.001 |
Family history of diabetes | 2.3(1.3–4.3) | 0.008 | 1.3(0.7–2.2) | 0.388 | 1.8(0.9–3.6) | 0.081 | 0.67(0.34–1.32) | 0.247 | 0.022 |
Family history of hypertension | 1.5(1.0-2.3) | 0.077 | 1.1(0.7–1.8) | 0.649 | 1.4(0.8–2.3) | 0.250 | 0.91(0.52–1.60) | 0.746 | 0.213 |
Current or ever smoker | 0.94(0.27–3.25) | 0.928 | 0.70(0.27–1.80) | 0.456 | 1.9(0.5–7.9) | 0.373 | 0.87(0.31–2.44) | 0.793 | 0.241 |
Parous | 1.2(0.7–2.3) | 0.519 | 1.3(0.8–2.2) | 0.225 | 0.68(0.29–1.58) | 0.365 | 0.93(0.53–1.65) | 0.810 | 0.631 |
History of GDM in previous pregnancy | 12.2(1.1-135.3) | 0.042 | 8.3(3.3–20.7) | < 0.001 | 2.4(0.1–44.6) | 0.552 | 8.3(2.8–24.4) | < 0.001 | < 0.001 |
Male fetus | 0.97(0.63–1.49) | 0.873 | 1.0(0.6–1.6) | 0.988 | 0.94(0.56–1.58) | 0.822 | 0.82(0.48–1.42) | 0.480 | 0.754 |