Wu Xiaodong, Tiemeier Henning, Xu Tingting
School of Public Health, Capital Medical University, Beijing, China.
Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
Rev Endocr Metab Disord. 2025 Jul 15. doi: 10.1007/s11154-025-09987-0.
This study examines the 34-year trends in gestational diabetes mellitus (GDM) prevalence in China, analyzing diagnostic shifts, regional variations, and urban-rural disparities. A comprehensive search of PubMed, Scopus, EMBASE, Google Scholar, WanFang, and China National Knowledge Infrastructure was conducted, ultimately including 1,105 articles after screening and data extraction. The study used multilevel meta-analysis to calculate pooled GDM prevalence and meta-regression to estimate trends and identify sources of heterogeneity. The results show that GDM prevalence based on the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria was 2 to 3 times higher (15.6%, [95% CI 14.9-16.2%]) in pregnant women post-2010, compared to other criteria (e.g., World Health Organization: 7.1%, [95%CI 4.1-10.0%]). A consistent upward trend in GDM prevalence was observed across all criteria except for ADA/C&C samples. Notably, the urban-rural gap in GDM prevalence is narrowing, with rural areas experiencing a faster increase in GDM rates (rural: 0.90% per year, urban: 0.60% per year). Additionally, regional differences are becoming less pronounced. The study highlights the significant and rapid rise in GDM prevalence in China over the past 34 years, with a notable shift in regional patterns. The narrowing of the urban-rural disparity and the diminishing regional differences underscore the need for unified national guidelines and targeted healthcare strategies to address the growing prevalence of GDM across diverse populations.Protocol registration.Systematic review registration PROSPERO CRD42019135521.
本研究考察了中国妊娠期糖尿病（GDM）患病率34年的变化趋势，分析了诊断标准的转变、地区差异和城乡差距。对PubMed、Scopus、EMBASE、谷歌学术、万方和中国知网进行了全面检索，经筛选和数据提取后最终纳入1105篇文章。该研究采用多水平荟萃分析计算合并的GDM患病率，并通过荟萃回归估计趋势和识别异质性来源。结果显示，与其他标准（如世界卫生组织：7.1%，[95%置信区间4.1 - 10.0%]）相比，基于国际糖尿病与妊娠研究组（IADPSG）标准的2010年后孕妇GDM患病率高出2至3倍（15.6%，[95%置信区间14.9 - 16.2%]）。除ADA/C&C样本外，所有标准下GDM患病率均呈现一致的上升趋势。值得注意的是，GDM患病率的城乡差距正在缩小，农村地区GDM患病率增长更快（农村：每年0.90%，城市：每年0.60%）。此外，地区差异也在变得不那么明显。该研究强调了过去34年中国GDM患病率显著且快速上升，地区模式发生了显著变化。城乡差距的缩小和地区差异的减小凸显了制定统一的国家指南和有针对性的医疗保健策略以应对不同人群中GDM患病率不断上升的必要性。方案注册。系统评价注册PROSPERO CRD42019135521。
