Social & Scientific Systems, Inc., 8757 Georgia Ave., Silver Spring, MD 20910, USA.
National Institute of Diabetes and Digestive and Kidney Diseases, 6707 Democracy Blvd, Bethesda, MD 20892, USA.
Diabetes Res Clin Pract. 2018 Jul;141:200-208. doi: 10.1016/j.diabres.2018.05.010. Epub 2018 May 26.
The true prevalence of gestational diabetes (GDM) in the United States is unknown. This study determined the prevalence of GDM and a subsequent diagnosis of diabetes in a nationally representative sample of U.S. women.
The crude and age-adjusted prevalence of GDM and subsequent diabetes were evaluated by sociodemographic and health-related characteristics among women age ≥20 years in the National Health and Nutrition Examination Surveys, 2007-2014 (N = 8185). Logistic regression analyzed independent factors associated with GDM and subsequent diabetes.
The prevalence of GDM was 7.6%. Women who were Mexican American (vs. non-Hispanic white), had ≥4 live births (vs. 1), had a family history of diabetes, or were obese (vs. normal weight) had a higher age-standardized prevalence of GDM (each p < 0.04). Among women with a history of GDM, 19.7% had a subsequent diagnosis of diabetes; subsequent diabetes diagnosis was higher for those with health insurance, more time since GDM diagnosis, greater parity, family history of diabetes, and obesity, and lower for those with higher education and income (all p ≤ 0.005). By logistic regression, significant factors associated with GDM were age at first birth, parity, family history of diabetes, and obesity; significant factors for subsequent diabetes were older age, greater years since GDM diagnosis, less education, family history of diabetes, and obesity (each p < 0.01).
The prevalence of GDM in the U.S. was 7.6%, with 19.7% of these women having a subsequent diabetes diagnosis. Women with a history of GDM, family history of diabetes, and obesity should be carefully monitored for dysglycemia.
美国妊娠糖尿病（GDM）的真实患病率尚不清楚。本研究旨在通过对美国≥20 岁女性进行全国代表性样本调查，确定 GDM 及随后诊断为糖尿病的患病率。
对 2007-2014 年全国健康与营养调查（NHANES）中年龄≥20 岁的女性进行社会人口统计学和与健康相关的特征分析，评估 GDM 及随后糖尿病的粗患病率和年龄调整后患病率。采用 logistic 回归分析与 GDM 和随后糖尿病相关的独立因素。
GDM 的患病率为 7.6%。与非西班牙裔白人相比，墨西哥裔美国人（vs. 非西班牙裔白人）、生育次数≥4 次（vs. 1 次）、有糖尿病家族史或肥胖（vs. 正常体重）的女性 GDM 年龄标准化患病率更高（p 值均<0.04）。在有 GDM 病史的女性中，有 19.7%随后被诊断为糖尿病；有医疗保险、距 GDM 诊断时间更长、生育次数更多、有糖尿病家族史和肥胖的女性，随后诊断为糖尿病的可能性更高；而受教育程度和收入较高的女性，随后诊断为糖尿病的可能性更低（均 p≤0.005）。logistic 回归分析显示，与 GDM 相关的显著因素为初产年龄、生育次数、糖尿病家族史和肥胖；与随后糖尿病相关的显著因素为年龄较大、距 GDM 诊断时间更长、受教育程度较低、糖尿病家族史和肥胖（p 值均<0.01）。
美国 GDM 的患病率为 7.6%，其中 19.7%的女性随后被诊断为糖尿病。有 GDM 病史、糖尿病家族史和肥胖的女性应密切监测血糖异常。
