Risk factors for gestational diabetes mellitus in Chinese women-a prospective study of 16 286 pregnant women in China

Aims To determine the incidence of gestational diabetes mellitus (GDM) in China and to further identify population specific risk factors for GDM. Methods Following a universal GDM screening recommendation, 16 286 pregnant women who underwent a 50-g glucose challenge test from 18 cities in China were followed up through pregnancy. GDM was confirmed by oral glucose tolerance test according to American Diabetes Association criteria. Results The incidence of GDM was 4.3%. Previously reported risk factors for GDM, including advanced maternal age, pre-pregnancy obesity and family history of diabetes, were strongly associated with an elevated GDM risk. Moreover, after the adjustment for the above-mentioned risk factors, a history of recurrent vulvovaginal candidiasis, residency in south China and a history of spontaneous abortion were significantly associated with an increased GDM risk; adjusted odds ratio (OR) [95% confidence interval (95% CI)] were 1.97 (1.39, 2.80), 1.84 (1.59-2.13), and 1.46 (1.12, 1.91), respectively. Conclusions In this large study of GDM in Chinese women, advanced maternal age, pre-pregnancy overweight or obesity and family history of diabetes were confirmed to be risk factors. In addition, a history of recurrent vulvovaginal candidiasis or spontaneous abortion and residency in south China appeared to be novel risk factors in this population.