Aljohani Naji, Rempel Brenda M, Ludwig Sora, Morris Margaret, McQuillen Kelly, Cheang Mary, Murray Robert, Shen Garry X
Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
Clin Invest Med. 2008;31(3):E131-7. doi: 10.25011/cim.v31i3.3470.
This retrospective cohort study was designed to examine the prevalence and risk factors of gestational diabetes mellitus (GDM) in Manitoba.
A total of 324,605 deliveries by 165,969 women were reported to Manitoba Health in the years 1985-2004. Data on maternal ages, delivery dates, GDM, self-declared First Nation (FN) status, rural or urban residence and previous GDM were collected for the study. Data were analyzed using multivariate logistic regression models.
The prevalence of GDM during the 20-year period was 2.9%, which was 2.3% in 1985-1989 and 3.7% in 1999-2004 (P < 0.01). The trend of increase in the prevalence of GDM continued after major modifications on the screening and diagnostic criteria for GDM in 1998. The prevalence of GDM in FN women was 3-times greater than that in non-FN women. Higher prevalence of GDM was detected in FN pregnant women living in rural areas compared to those in urban areas (P < 0.01), which was opposite for non-FN pregnant women living in rural and urban areas. The prevalence of GDM in pregnant women > or =35 yr was 2.3-fold higher than that in those < 35 yr (P < 0.01). The recurrent rate of GDM was 44.4%. Adjusted odds ratios of GDM for FN status, advanced age, a history of GDM and rural living were 2.2, 2.4, 25.1 and 0.8, respectively.
The prevalence of GDM is increased in Manitoba. FN status, advanced age and a history of GDM, but not rural living, are independent predictors for GDM.
本回顾性队列研究旨在调查曼尼托巴省妊娠期糖尿病（GDM）的患病率及危险因素。
1985年至2004年间，曼尼托巴省卫生部共报告了165,969名女性的324,605次分娩情况。研究收集了产妇年龄、分娩日期、GDM、自我申报的原住民（FN）身份、城乡居住情况及既往GDM病史等数据。采用多因素逻辑回归模型对数据进行分析。
20年间GDM的患病率为2.9%，1985 - 1989年为2.3%，1999 - 2004年为3.7%（P < 0.01）。1998年对GDM筛查和诊断标准进行重大修订后，GDM患病率仍呈上升趋势。FN女性的GDM患病率是非FN女性的3倍。居住在农村地区的FN孕妇的GDM患病率高于城市地区（P < 0.01），而对于非FN孕妇，城乡情况则相反。年龄≥35岁孕妇的GDM患病率比<35岁孕妇高2.3倍（P < 0.01）。GDM复发率为44.4%。根据FN身份、高龄、既往GDM病史及农村居住情况调整后的GDM比值比分别为2.2、2.4、25.1和0.8。
曼尼托巴省GDM患病率有所上升。FN身份、高龄和既往GDM病史是GDM的独立预测因素，而农村居住情况不是。
