Rao Arathi P, Khatib Mahalaqua Nazli, Thangavelu Lakshmi, Roopashree Rangaswamy, Sharma Pawan, Lal Madan, Barwl Amit, Prasad Garbham Venkata Siva, Rajput Pranchal, Zahiruddin Quazi Syed, Sah Sanjit, Pant Kumud, Satapathy Prakasini
Department of Health Policy, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India.
Division of Evidence Synthesis, Global Consortium of Public Health and Research, Datta Meghe Institute of Higher Education, Wardha, India.
Asia Pac J Public Health. 2025 Mar;37(2-3):200-207. doi: 10.1177/10105395241305671. Epub 2024 Dec 25.
Gestational diabetes mellitus (GDM) is a major global health concern, affecting maternal and child health. Although genetic predispositions and individual medical histories are well-recognized risk factors, emerging research suggests a significant impact of external factors like neighborhood socioeconomic characteristics. This study systematically reviews and meta-analyzes the association between neighborhood deprivation and GDM incidence. We searched multiple databases up to January 10, 2024, for studies linking neighborhood deprivation with GDM. Eligible studies were selected based on predefined criteria, with the Nested Knowledge software assisting in screening and data extraction. Quality assessment utilized the Newcastle-Ottawa Scale, and a random-effects model computed the pooled relative risk (RR) using R software, version 4.3. The review included six studies varying significantly in design, sample sizes, and deprivation assessment methods. The meta-analysis combined data from five studies totaling 15 827 participants from the least deprived and 18 147 from the most deprived neighborhoods, yielding an RR of 0.909, indicating a non-significant lower risk of GDM in more deprived groups. A substantial heterogeneity (I = 70%) was observed, and sensitivity analysis confirmed the robustness of these findings. This analysis suggests that living in a deprived neighborhood does not significantly alter GDM risk, underscoring the necessity for further research to refine public health strategies and interventions. The variability in neighborhood deprivation definitions and potential unaccounted confounding factors highlight the need for comprehensive studies, especially from low-income and middle-income countries, to elucidate the intricate links between socioeconomic factors and GDM.
妊娠期糖尿病（GDM）是一个重大的全球健康问题，影响着母婴健康。尽管遗传易感性和个人病史是公认的风险因素，但新出现的研究表明，邻里社会经济特征等外部因素也有重大影响。本研究系统回顾并荟萃分析了邻里贫困与GDM发病率之间的关联。我们检索了截至2024年1月10日的多个数据库，以查找将邻里贫困与GDM联系起来的研究。符合条件的研究根据预先定义的标准进行选择，Nested Knowledge软件协助进行筛选和数据提取。质量评估采用纽卡斯尔-渥太华量表，随机效应模型使用R软件4.3版计算合并相对风险（RR）。该综述纳入了六项研究，这些研究在设计、样本量和贫困评估方法上有很大差异。荟萃分析合并了五项研究的数据，这些研究共有来自最不贫困社区的15827名参与者和来自最贫困社区的18147名参与者，得出RR为0.909，表明在贫困程度较高的群体中，GDM风险略低但不显著。观察到存在显著异质性（I² = 70%），敏感性分析证实了这些结果的稳健性。该分析表明，生活在贫困社区并不会显著改变GDM风险，这凸显了进一步研究以完善公共卫生策略和干预措施的必要性。邻里贫困定义的差异以及潜在的未考虑到的混杂因素凸显了进行全面研究的必要性，特别是来自低收入和中等收入国家的研究，以阐明社会经济因素与GDM之间的复杂联系。
