Collier Andrew, Abraham E Christie, Armstrong Julie, Godwin Jon, Monteath Kirsten, Lindsay Robert
University Hospital Ayr, Ayr, UK.
Institute for Applied Health Research, Institute for Society and Social Justice Research, Glasgow, Scotland, UK.
J Diabetes Investig. 2017 Mar;8(2):161-167. doi: 10.1111/jdi.12552. Epub 2016 Aug 27.
AIMS/INTRODUCTION: Gestational diabetes mellitus (GDM) is defined as 'carbohydrate intolerance of varying degrees of severity with onset or first recognition during pregnancy,' and is associated with increased fetal and maternal risks. The aims of the present study were to investigate the prevalence of GDM in Scotland over 32 years (1981-2012), and using the data from 2012, to assess how GDM related to maternal body mass index, maternal age, parity, smoking, Scottish Index of Multiple Deprivation, infant gender and macrosomia status.
GDM prevalence along with anthropometric, obstetric and demographic data were collected on a total of 1,891,097 women with a delivery episode between 1 January 1981 and 31 December 2012 using data extracted from the Scottish Morbidity Record 02. Univariate and multivariate logistic regression analysis was undertaken to investigate their association with GDM.
A ninefold increase in GDM prevalence was observed from 1981 to 2012 (P < 0.001). GDM prevalence in 2012 was 1.9%. Maternal body mass index, age, parity status, Scottish index of multiple deprivation and fetal macrosomia were positively associated with GDM. Reported smoking status at booking was inversely associated with GDM. Multivariable analysis showed that fetal macrosomia was not associated with GDM status.
The present study confirmed that the reporting of GDM is low in Scotland, and that GDM is associated with maternal body mass index, maternal age, multiparity and social deprivation. GDM was negatively associated with smoking and requires further investigation. The lack of association between GDM and macrosomia (following multivariate analysis) might reflect the screening processes undertaken in Scotland.
目的/引言：妊娠期糖尿病（GDM）被定义为“在孕期出现或首次被识别的不同程度的碳水化合物不耐受”，并且与胎儿和母亲风险增加相关。本研究的目的是调查32年间（1981 - 2012年）苏格兰妊娠期糖尿病的患病率，并利用2012年的数据评估妊娠期糖尿病与母亲体重指数、母亲年龄、产次、吸烟、苏格兰多重剥夺指数、婴儿性别和巨大儿状态之间的关系。
使用从苏格兰发病率记录02中提取的数据，收集了1981年1月1日至2012年12月31日期间共有1,891,097名有分娩记录的女性的妊娠期糖尿病患病率以及人体测量、产科和人口统计学数据。进行单因素和多因素逻辑回归分析以研究它们与妊娠期糖尿病的关联。
1981年至2012年期间观察到妊娠期糖尿病患病率增加了九倍（P < 0.001）。2012年妊娠期糖尿病患病率为1.9%。母亲体重指数、年龄、产次状态、苏格兰多重剥夺指数和胎儿巨大儿与妊娠期糖尿病呈正相关。登记时报告的吸烟状态与妊娠期糖尿病呈负相关。多变量分析表明胎儿巨大儿与妊娠期糖尿病状态无关。
本研究证实苏格兰妊娠期糖尿病的报告率较低，并且妊娠期糖尿病与母亲体重指数、母亲年龄、多产和社会剥夺相关。妊娠期糖尿病与吸烟呈负相关，需要进一步研究。妊娠期糖尿病与巨大儿之间缺乏关联（多变量分析后）可能反映了苏格兰所采用的筛查过程。
