Department of Maternal and Child Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Diabet Med. 2017 Oct;34(10):1421-1427. doi: 10.1111/dme.13415. Epub 2017 Jul 12.
The relationship between socio-economic status and gestational diabetes mellitus has received little attention. The purpose of this study was to investigate the association between socio-economic status and risk of gestational diabetes.
Data were obtained from the ongoing Healthy Baby Cohort study in Hubei Province, China, in 2012-2014. Information on educational level and household income was collected using standard questionnaires during face-to-face interviews. Gestational diabetes was defined based on the International Association of Diabetes and Pregnancy Study Group's criteria. Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for gestational diabetes in relation to socio-economic status.
Among 6886 participants, 1005 (14.6%) pregnant women were diagnosed with gestational diabetes. Higher educational level was inversely associated with risk of gestational diabetes (OR, 0.74; 95% CI, 0.58, 0.95 for high school and OR, 0.62; 95% CI, 0.50, 0.76 for college or above). After adjustment for potential confounders, the ORs for gestational diabetes were 0.77 (95% CI, 0.59, 1.00) and 0.65 (95% CI, 0.51, 0.83) for women with high school and college or above education, respectively, compared with women with less than high school education. No significant association between household income and gestational diabetes was observed after adjustment for potential confounders. Subgroup analysis showed that the reduced risk of gestational diabetes with higher educational level was more evident among women with a pre-pregnancy BMI < 24 kg/m (P for interaction = 0.022).
Our findings suggested that educational level was a more robust predictor of gestational diabetes than household income among Chinese women.
社会经济地位与妊娠糖尿病之间的关系尚未得到充分关注。本研究旨在探讨社会经济地位与妊娠糖尿病风险之间的关联。
数据来自 2012-2014 年期间在中国湖北省进行的“健康婴儿队列研究”。通过面对面访谈使用标准问卷收集教育水平和家庭收入信息。根据国际糖尿病与妊娠研究组的标准，定义妊娠糖尿病。使用逻辑回归模型估计与社会经济地位相关的妊娠糖尿病的比值比（OR）和 95%置信区间（CI）。
在 6886 名参与者中，有 1005 名（14.6%）孕妇被诊断为妊娠糖尿病。较高的教育水平与妊娠糖尿病的风险呈负相关（OR，0.74；95%CI，0.58，0.95 为高中及 OR，0.62；95%CI，0.50，0.76 为大学或以上）。在调整潜在混杂因素后，与教育程度低于高中的女性相比，高中和大学及以上学历的女性发生妊娠糖尿病的 OR 分别为 0.77（95%CI，0.59，1.00）和 0.65（95%CI，0.51，0.83）。在调整潜在混杂因素后，家庭收入与妊娠糖尿病之间没有显著关联。亚组分析表明，在孕前 BMI<24kg/m2 的女性中，较高的教育水平降低妊娠糖尿病风险的作用更为明显（P 交互=0.022）。
我们的研究结果表明，在中国女性中，教育水平是预测妊娠糖尿病的一个比家庭收入更为有力的指标。
