Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Folkhälsan Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Diabet Med. 2019 Feb;36(2):214-220. doi: 10.1111/dme.13834.
Findings concerning the impact of socio-economic status on the risk of gestational diabetes mellitus (GDM) are inconclusive and little is known about the simultaneous impact of income and educational attainment on the risk of GDM. This study aims to assess the impact of maternal prepregnancy income in combination with traditional GDM risk factors on the incidence of GDM in primiparous women.
This is an observational cohort study including 5962 Finnish women aged ≥ 20 years from the city of Vantaa, Finland, who delivered for the first time between 2009 and 2015, excluding women with pre-existing diabetes mellitus. The Finnish Medical Birth Register, Finnish Tax Administration, Statistics Finland, Social Insurance Institution of Finland and patient healthcare records provided data for the study. We divided the study population according to five maternal income levels and four educational attainment levels.
Incidence of GDM decreased with increasing income level in primiparous women (P < 0.001 for linearity, adjusted for smoking, age, BMI and cohabiting status). In an adjusted two-way model, the relationship was significant for both income (P = 0.007) and education (P = 0.039), but there was no interaction between income and education (P = 0.52).
There was an inverse relationship between both maternal prepregnancy taxable income and educational attainment, and the risk of GDM in primiparous Finnish women.
关于社会经济地位对妊娠期糖尿病(GDM)风险的影响的研究结果尚无定论,对于收入和教育程度对 GDM 风险的综合影响知之甚少。本研究旨在评估初产妇母亲孕前收入与传统 GDM 危险因素相结合对 GDM 发生率的影响。
这是一项观察性队列研究,纳入了芬兰万塔市年龄≥20 岁的 5962 名初产妇,排除了患有糖尿病的女性,这些女性于 2009 年至 2015 年间首次分娩。芬兰医疗出生登记处、芬兰税务管理局、芬兰统计局、芬兰社会保险局和患者医疗记录为该研究提供了数据。我们根据母亲的五个收入水平和四个教育程度水平对研究人群进行了划分。
在初产妇中,GDM 的发病率随收入水平的增加而降低(线性趋势 P<0.001,调整了吸烟、年龄、BMI 和同居状况)。在调整后的双向模型中,收入(P=0.007)和教育程度(P=0.039)均与 GDM 风险相关,但收入和教育程度之间没有相互作用(P=0.52)。
在芬兰初产妇中,母亲孕前应税收入和教育程度与 GDM 风险呈负相关。