Center of Obstetrics and Gynecology, Peking University Shenzhen Hospital, 1120 Lianhua Road, Shenzhen, 518036, Guangdong, China.
Institute of Obstetrics and Gynecology, Shenzhen PKU-HKUST Medical Center, Shenzhen, Guangdong, China.
BMC Pregnancy Childbirth. 2024 Jun 4;24(1):406. doi: 10.1186/s12884-024-06602-z.
Interpregnancy interval (IPI) is associated with the risk of GDM in a second pregnancy. However, an optimal IPI is still need to be determined based on the characteristics of the population. This study aimed to analyze the effect of interpregnancy interval (IPI) on the risk of gestational diabetes mellitus (GDM) in the Chinese population.
We conducted a retrospective cohort study on female participants who had consecutive deliveries at Peking University Shenzhen Hospital from 2013 to 2021. The IPI was categorized into 7 groups and included into the multivariate logistic regression model with other confound factors. Analysis was also stratified based on age of first pregnancy, BMI, and history of GDM. Adjusted OR values (aOR) and 95% confidence intervals (CI) calculated. The regression coefficient of IPI months on GDM prediction risk was analyzed using a linear regression model.
A total of 2,392 participants were enrolled. The IPI of the GDM group was significantly greater than that of the non-GDM group (P < 0.05). Compared with the 18-24 months IPI category, participants with longer IPIs (24-36 months, 36-48 months, 48-60 months, and ≥ 60 months) had a higher risk of GDM (aOR:1.585, 2.381, 2.488, and 2.565; 95% CI: 1.021-2.462, 1.489-3.809, 1.441-4.298, and 1.294-5.087, respectively). For participants aged < 30 years or ≥ 30 years or without GDM history, all longer IPIs (≥ 36 months) were all significantly associated with the GDM risk in the second pregnancy (P < 0.05), while any shorter IPIs (< 18 months) was not significantly associated with GDM risk (P > 0.05). For participants with GDM history, IPI 12-18 months, 24-36 months, 36-48 months, and ≥ 60 months were all significantly associated with the GDM risk (aOR: 2.619, 3.747, 4.356, and 5.373; 95% CI: 1.074-6.386, 1.652-8.499, 1.724-11.005, and 1.078-26.793, respectively), and the slope value of linear regression (0.5161) was significantly higher compared to participants without a history of GDM (0.1891) (F = 284.168, P < 0.001).
Long IPI increases the risk of GDM in a second pregnancy, but this risk is independent of maternal age. The risk of developing GDM in a second pregnancy for women with GDM history is more significantly affected by IPI.
妊娠间隔（interpregnancy interval，IPI）与第二次妊娠发生妊娠期糖尿病（gestational diabetes mellitus，GDM）的风险相关。然而，基于人群特征，仍需要确定最佳的 IPI。本研究旨在分析中国人群中 IPI 对 GDM 风险的影响。
我们对 2013 年至 2021 年期间在北京大学生深圳医院连续分娩的女性参与者进行了回顾性队列研究。将 IPI 分为 7 组，并将其与其他混杂因素纳入多变量逻辑回归模型进行分析。还根据首次妊娠年龄、BMI 和 GDM 史进行了分层分析。计算了调整后的比值比（adjusted OR，aOR）及其 95%置信区间（95% confidence interval，CI）。使用线性回归模型分析 IPI 月数对 GDM 预测风险的回归系数。
共纳入 2392 名参与者。GDM 组的 IPI 明显大于非 GDM 组（P<0.05）。与 18-24 个月 IPI 类别相比，较长 IPI（24-36 个月、36-48 个月、48-60 个月和≥60 个月）的参与者发生 GDM 的风险更高（aOR：1.585、2.381、2.488 和 2.565；95%CI：1.021-2.462、1.489-3.809、1.441-4.298 和 1.294-5.087）。对于年龄<30 岁或≥30 岁或无 GDM 史的参与者，所有较长的 IPI（≥36 个月）均与第二次妊娠的 GDM 风险显著相关（P<0.05），而任何较短的 IPI（<18 个月）与 GDM 风险均无显著相关性（P>0.05）。对于有 GDM 史的参与者，12-18 个月、24-36 个月、36-48 个月和≥60 个月的 IPI 均与 GDM 风险显著相关（aOR：2.619、3.747、4.356 和 5.373；95%CI：1.074-6.386、1.652-8.499、1.724-11.005 和 1.078-26.793），线性回归的斜率值（0.5161）明显高于无 GDM 史的参与者（0.1891）（F=284.168，P<0.001）。
较长的 IPI 会增加第二次妊娠发生 GDM 的风险，但这种风险与产妇年龄无关。有 GDM 史的女性再次妊娠发生 GDM 的风险受 IPI 的影响更为显著。
Zotero 插件