Association of Parity with the Risks of Gestational Diabetes and Macrosomia: A Retrospective Cohort Study in Nanjing, China


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Abstract

Background:After implementing the two-child policy, more Chinese women who had a previous delivery had their second child. Nevertheless, the impacts of parity on Gestational Diabetes (GDM) and macrosomia have not been fully confirmed. Therefore, we aimed to analyse the characteristics of pregnancy by parity and evaluate the association of parity with risks of GDM/macrosomia in a Chinese population.

Methods:A total of 193,410 pregnant women (including 148,293 primiparae and 45,117 multiparae) with complete information were included. Univariate and multivariate logistic regression analyses were used to examine the association between parity and risks of GDM/macrosomia.

Results:With the gradual implementation of the two-child policy, the proportion of multiparae increased rapidly and then decreased slightly. Multiparae were more likely to be older and have higher intrapartum BMI, as compared to primiparae (p < 0.001). Univariate regression analyses suggested that parity could increase the risks of GDM and macrosomia; while after adjustment, the association between parity and GDM risk disappeared, and the effects of parity on macrosomia risk and birth weight of babies were also weakened. Further, stratified analysis showed that parity only increased the risk of GDM in women over 30 years, and the effects of parity on macrosomia risk and birth weight were more pronounced among women over 30 years compared to women under 30 years.

Conclusion:Parity was not associated with GDM risk, but mildly associated with macrosomia risk. Particular attention should be paid to multiparae with advanced age to reduce the risks of GDM and macrosomia.

About the authors

Shijie Geng

Nanjing Maternity and Child Health Care Institute, Nanjing Women and Children’s Healthcare Hospital, Women’s Hospital of Nanjing Medical University

Email: info@benthamscience.net

Junya Wang

Nanjing Maternity and Child Health Care Institute, Nanjing Women and Children’s Healthcare Hospital, Women’s Hospital of Nanjing Medical University,

Email: info@benthamscience.net

Zhi Geng

Department of Cardiovascular Surgery, The Second Affiliated Hospital of Nanjing Medical University

Email: info@benthamscience.net

Juan Wen

Nanjing Maternity and Child Health Care Institute, Nanjing Women and Children’s Healthcare Hospital, Women’s Hospital of Nanjing Medical University

Author for correspondence.
Email: info@benthamscience.net

References

  1. Zeng Y, Hesketh T. The effects of China’s universal two-child policy. Lancet 2016; 388(10054): 1930-8. doi: 10.1016/S0140-6736(16)31405-2 PMID: 27751400
  2. Hesketh T, Zhou X, Wang Y. The end of the one-child policy. JAMA 2015; 314(24): 2619-20. doi: 10.1001/jama.2015.16279 PMID: 26545258
  3. Lin L, Lu C, Chen W, Li C, Guo VY. Parity and the risks of adverse birth outcomes: A retrospective study among Chinese. BMC Pregnancy Childbirth 2021; 21(1): 257. doi: 10.1186/s12884-021-03718-4 PMID: 33771125
  4. Kc K, Shakya S, Zhang H. Gestational diabetes mellitus and macrosomia: A literature review. Ann Nutr Metab 2015; 66(S2): 14-20. doi: 10.1159/000371628 PMID: 26045324
  5. Chu AHY, Godfrey KM. Gestational diabetes mellitus and developmental programming. Ann Nutr Metab 2020; 76(S3): 4-15. doi: 10.1159/000509902 PMID: 33465774
  6. Lu Y, Zhang J, Lu X, Xi W, Li Z. Secular trends of macrosomia in southeast China, 1994-2005. BMC Public Health 2011; 11(1): 818. doi: 10.1186/1471-2458-11-818 PMID: 22011362
  7. Juan J, Yang H. Prevalence, prevention, and lifestyle intervention of gestational diabetes mellitus in China. Int J Environ Res Public Health 2020; 17(24): 9517. doi: 10.3390/ijerph17249517 PMID: 33353136
  8. Said AS, Manji KP. Risk factors and outcomes of fetal macrosomia in a tertiary centre in Tanzania: A case-control study. BMC Pregnancy Childbirth 2016; 16(1): 243. doi: 10.1186/s12884-016-1044-3 PMID: 27557930
  9. Zhang HX, Zhao YY, Wang YQ. Analysis of the characteristics of pregnancy and delivery before and after implementation of the two-child policy. Chin Med J 2018; 131(1): 37-42. doi: 10.4103/0366-6999.221268 PMID: 29271378
  10. Rao J, Fan D, Wu S, et al. Trend and risk factors of low birth weight and macrosomia in south China, 2005-2017: A retrospective observational study. Sci Rep 2018; 8(1): 3393. doi: 10.1038/s41598-018-21771-6 PMID: 29467433
  11. Koyanagi A, Zhang J, Dagvadorj A, et al. Macrosomia in 23 developing countries: An analysis of a multicountry, facility-based, cross-sectional survey. Lancet 2013; 381(9865): 476-83. doi: 10.1016/S0140-6736(12)61605-5 PMID: 23290494
  12. Luo L, Zeng H, Zeng M, et al. The second pregnancy has no effect in the incidence of macrosomia: A cross-sectional survey in two western Chinese regions. J Health Popul Nutr 2021; 40(1): 19. doi: 10.1186/s41043-021-00244-z PMID: 33849665
  13. Tai W, Hu L, Wen J. Maternal and neonatal outcomes after assisted reproductive technology: A retrospective cohort study in China. Front Med 2022; 9: 837762. doi: 10.3389/fmed.2022.837762 PMID: 35479950
  14. Wen J. Impact of COVID-19 pandemic on birth outcomes: A retrospective cohort study in Nanjing, China. Front Public Health 2022; 10: 923324. doi: 10.3389/fpubh.2022.923324 PMID: 35923970
  15. Brekke PH, Rama T, Pilán I, Nytrø Ø, Øvrelid L. Synthetic data for annotation and extraction of family history information from clinical text. J Biomed Semantics 2021; 12(1): 11. doi: 10.1186/s13326-021-00244-2 PMID: 34261535
  16. Metzger BE, Gabbe SG, Persson B, et al. International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycemia in pregnancy. Diabetes Care 2010; 33(3): 676-82. doi: 10.2337/dc09-1848 PMID: 20190296
  17. Schwartz N, Nachum Z, Green MS. The prevalence of gestational diabetes mellitus recurrence-effect of ethnicity and parity: A metaanalysis. Am J Obstet Gynecol 2015; 213(3): 310-7. doi: 10.1016/j.ajog.2015.03.011 PMID: 25757637
  18. Karcaaltincaba D, Calis P, Ocal N, Ozek A, Inan AM, Bayram M. Prevalence of gestational diabetes mellitus evaluated by universal screening with a 75-g, 2-hour oral glucose tolerance test and IADPSG criteria. Int J Gynaecol Obstet 2017; 138(2): 148-51. doi: 10.1002/ijgo.12205 PMID: 28494099
  19. Zhu WW, Yang HX, Wang C, Su RN, Feng H, Kapur A. High prevalence of gestational diabetes mellitus in Beijing. Chin Med J 2017; 130(9): 1019-25. doi: 10.4103/0366-6999.204930 PMID: 28469095
  20. Wen J, Kang C, Wang J, et al. Association of maternal serum 25-hydroxyvitamin D concentrations in second and third trimester with risk of macrosomia. Sci Rep 2018; 8(1): 6169. doi: 10.1038/s41598-018-24534-5 PMID: 29670182
  21. Usta A, usta CS, Yildiz A, et al. Frequency of fetal macrosomia and the associated risk factors in pregnancies without gestational diabetes mellitus. Pan Afr Med J 2017; 26: 62. doi: 10.11604/pamj.2017.26.62.11440 PMID: 28451039

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