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妊娠间隔与妊娠期糖尿病之间的关联:2020年国家生命统计系统队列研究

Association between interpregnancy interval and gestational diabetes mellitus: A cohort study of the National Vital Statistics System 2020.

作者信息

Zhu Xuejiao, Li Wei, Xi Hongli, Li Mingqun

机构信息

Department of Obstetrics and Gynecology, Xiangyang No.1 People's Hospital, Hubei University of Medicine, Xiangyang, Hubei, China.

出版信息

Int J Gynaecol Obstet. 2024 Jan;164(1):86-98. doi: 10.1002/ijgo.14929. Epub 2023 Jun 20.

Abstract

OBJECTIVE

To assess the association between interpregnancy interval (IPI) and gestational diabetes mellitus (GDM).

METHODS

Data of this retrospective cohort study were obtained from the National Vital Statistics System (NVSS) 2020. The participants were divided into different groups according to different IPI (<6, 6-11, 12-17, 18-23, 24-59 (reference), 60-119, ≥120 months). Multivariate logistic models were constructed to evaluate the association between IPI and GDM. Subgroup analysis was further performed.

RESULTS

A total of 1 515 263 women were included, with 123 951 (8.18%) having GDM. Compared with the 24-59 months group, the <6 months (odds ratio [OR] 0.64, 95% confidence interval [CI] 0.46-0.90, P = 0.009), 12-17 months (OR 0.96, 95% CI 0.94-0.98, P < 0.001), and 18-23 months (OR 0.94, 95% CI 0.93-0.96, P < 0.001) groups had a significantly lower risk of GDM, while the 60-119 months (OR 1.13, 95% CI 1.11-1.15, P < 0.001) and ≥120 months (OR 1.18, 95% CI 1.15-1.21, P < 0.001) groups had a significantly higher risk of GDM. No significant difference was observed in the risk of GDM between the 6-11 and 24-59 months groups (P = 0.542). The PI-GDM association varied across different groups of age, pre-pregnancy body mass index, pre-pregnancy smoking status, history of cesarean section, history of preterm birth, prior terminations, and parity.

CONCLUSION

An IPI of 18-23 months may be a better interval than 24-59 months in managing the risk of GDM.

摘要

目的

评估妊娠间隔(IPI)与妊娠期糖尿病(GDM)之间的关联。

方法

这项回顾性队列研究的数据来自2020年国家生命统计系统(NVSS)。参与者根据不同的IPI(<6、6 - 11、12 - 17、18 - 23、24 - 59(参照)、60 - 119、≥120个月)被分为不同组。构建多变量逻辑模型以评估IPI与GDM之间的关联,并进一步进行亚组分析。

结果

共纳入1515263名女性,其中123951名(8.18%)患有GDM。与24 - 59个月组相比,<6个月组(比值比[OR]0.64,95%置信区间[CI]0.46 - 0.90,P = 0.009)、12 - 17个月组(OR 0.96,95% CI 0.94 - 0.98,P < 0.001)和18 - 23个月组(OR 0.94,95% CI 0.93 - 0.96,P < 0.001)患GDM的风险显著较低,而60 - 119个月组(OR 1.13,95% CI 1.11 - 1.15,P < 0.001)和≥120个月组(OR 1.18,95% CI 1.15 - 1.21,P < 0.001)患GDM的风险显著较高。6 - 11个月组与24 - 59个月组之间在GDM风险上未观察到显著差异(P = 0.542)。PI - GDM关联在不同年龄、孕前体重指数、孕前吸烟状况、剖宫产史、早产史、既往终止妊娠史和产次组中有所不同。

结论

在管理GDM风险方面,18 - 23个月的IPI可能比24 - 59个月是更好的间隔。

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