Prevalence and Determinants of Gestational Diabetes Mellitus: A Cross-Sectional Study in China
Abstract
:1. Introduction
2. Methods
2.1. Research Methods
2.2. Sociodemographic Variables
3. Behavioral Factors
3.1. Routine Life
3.2. Physical Activity
3.3. Screen Time
3.4. Number of Meals per Day
3.5. Breakfast
3.6. Sleeping Duration
3.7. Quality of Sleep
3.8. Currently Smoking and Secondhand Smoke Exposure
4. BMI Category
4.1. BMI Group by Category of China
4.2. BMI Group by Category of World Health Organization
5. Disease Conditions
5.1. Outcome Variable
5.2. Data Analyses
6. Results
6.1. Characteristics of Study Participants
6.2. Univariate Logistic Regression Analysis of Factors That Affect Gestational Diabetes Mellitus
6.3. Multivariable Logistic Regression Analysis for Gestational Diabetes Mellitus
7. Discussion
8. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
References
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Variable | Gestational Diabetes Mellitus | |
---|---|---|
No | Yes | |
Sociodemographic | ||
Number of pregnancy | ||
First pregnancy | 1695 (96.6) | 60 (3.4) |
Second pregnancy | 563 (95.4) | 27 (4.6) |
Nationality | ||
Han nationality | 2167 (96.2) | 85 (3.8) |
Minority | 91 (97.9) | 2 (2.1) |
Marital status | ||
Married | 2126 (96.4) | 79 (3.6) |
Unmarried | 46 (93.9) | 3 (6.1) |
Remarried | 66 (94.3) | 4 (5.7) |
Divorced or Widowed | 20 (95.2) | 1 (4.8) |
Education level | ||
Basic education | 389 (96.8) | 13 (3.2) |
Secondary education | 342 (96.6) | 12 (3.4) |
Higher education | 1527 (96.1) | 62 (3.9) |
Residence | ||
Urban area | 1801 (95.8) | 79 (4.2) |
Rural area | 457 (98.3) | 8 (1.7) |
Income | ||
Low | 595 (97.4) | 16 (2.6) |
Medium | 957 (96.8) | 32 (3.2) |
High | 706 (94.8) | 39 (5.2) |
Occupation | ||
Rural migrant workers | 116 (98.3) | 2 (1.7) |
Urban and rural unemployed | 531 (96.0) | 22 (4.0) |
Industrial workers of non-agriculturalRegistered permanent residence | 49 (98.0) | 1 (2.0) |
Individual business | 189 (95.0) | 10 (5.0) |
Business services staff | 148 (95.5) | 7 (4.5) |
Civil servants | 388 (97.5) | 10 (2.5) |
Senior manager and Middle-level managerIn large and medium enterprise | 92 (95.8) | 4 (4.2) |
Private entrepreneur | 80 (91.9) | 7 (8.1) |
Professionals | 232 (95.1) | 12 (4.9) |
Clerks | 138 (99.3) | 1 (0.7) |
Students | 15 (100.0) | 0 (0.0) |
Others | 280 (96.2) | 11 (3.8) |
Trimester of pregnancy | ||
Early pregnant women | 289 (98.6) | 4 (1.4) |
Mid-pregnancy women | 693 (98.9) | 8 (1.1) |
Late-pregnant women | 1276 (94.5) | 75 (5.5) |
Age (years) | ||
18–25 | 613 (98.2) | 11 (1.8) |
26–35 | 1531 (96.0) | 64 (4.0) |
36–45 | 114 (90.5) | 12 (9.5) |
Behavioral factors | ||
TV viewing time per day (hours) | ||
<2 | 1695 (96.5) | 62 (3.5) |
2~4 | 411 (96.7) | 14 (3.3) |
>4 | 152 (93.3) | 11 (6.8) |
Computer using time per day (hours) | ||
<2 | 1796 (96.4) | 67 (3.6) |
2~4 | 177 (95.7) | 8 (4.3) |
>4 | 285 (96.0) | 12 (4.0) |
Mobile phone using time per day (hours) | ||
<1 | 838 (95.4) | 40 (4.6) |
1~2 | 604 (97.1) | 18 (2.9) |
2~4 | 520 (97.0) | 16 (3.0) |
4~6 | 178 (94.7) | 10 (5.3) |
>6 | 118 (97.5) | 3 (2.5) |
Physical activity | ||
Insufficient | 325 (97.3) | 9 (2.7) |
Sufficient | 1933 (96.1) | 78 (3.9) |
Secondhand smoke exposure | ||
None exposure | 1098 (96.1) | 45 (3.9) |
Every day | 397 (97.5) | 10 (2.5) |
Four to six days per week | 151 (96.2) | 6 (3.8) |
One to three per week | 612 (95.9) | 26 (4.1) |
Smoking during the pregnancy | ||
No | 2171 (96.3) | 84 (3.7) |
Yes | 87 (96.7) | 3 (33.3) |
Breakfast every day | ||
No | 247 (95.4) | 12 (4.6) |
Yes | 2011 (96.4) | 75 (3.6) |
Self-reported routine life during pregnancy | ||
Regular | 1220 (96.1) | 50 (3.9) |
Average | 835 (96.5) | 30 (3.5) |
Irregular | 203 (96.7) | 7 (3.3) |
Number of meal per day during the pregnancy | ||
3 times | 1150 (96.1) | 47 (3.9) |
<3 times | 44 (95.7) | 2 (4.4) |
4 times | 838 (96.8) | 28 (3.2) |
≥5 times | 226 (95.8) | 10 (4.2) |
Sleep duration during the pregnancy | ||
Normal sleep duration | 1258 (96.8) | 41 (3.2) |
Insufficient sleeping duration | 533 (95.0) | 28 (5.0) |
Excessive sleep duration | 467 (96.3) | 18 (3.7) |
Sleep quality status | ||
Good | 800 (96.7) | 27 (3.3) |
Average | 1117 (96.3) | 43 (3.7) |
Poor | 341 (95.3) | 17 (4.8) |
BMI group by category of China | ||
Normal | 1050 (96.6) | 37 (3.4) |
Low | 123 (98.4) | 2 (1.6) |
Overweight | 826 (96.5) | 30 (3.5) |
Obesity | 259 (93.5) | 18 (6.5) |
BMI group by category of World Health Organization | ||
Normal | 1333 (96.6) | 47 (3.4) |
Low | 123 (98.4) | 2 (1.6) |
Overweight | 704 (96.2) | 28 (3.8) |
Obesity | 98 (90.7) | 10 (9.3) |
Anemia | ||
No | 1968 (96.1) | 79 (3.9) |
Yes | 290 (97.3) | 8 (2.7) |
Hypertension | ||
No | 2246 (96.4) | 85 (3.7) |
Yes | 12 (85.7) | 2 (14.3) |
Variable | OR (95% CI) | p-Value |
---|---|---|
Nationality | ||
Minority vs. Han nationality | 0.56 (0.14, 2.31) | 0.423 |
Marital status | ||
Unmarried vs. Married | 1.76 (0.53, 5.77) | 0.354 |
Remarried vs. Married | 1.63 (0.58, 4.59) | 0.354 |
Divorced or Widowed vs. Married | 1.35 (0.18, 10.15) | 0.773 |
Education level | ||
Secondary education vs. Basic education | 1.05 (0.47, 2.33) | 0.905 |
Higher education vs. Basic education | 1.22 (0.66, 2.23) | 0.530 |
Residence | ||
Urban area vs. Rural area | 2.51 (1.20, 5.22) | 0.014 |
Income | ||
Medium vs. Low | 1.24 (0.68, 2.29) | 0.483 |
High vs. Low | 2.05 (1.14, 3.71) | 0.017 |
Job conditions status | ||
Manual vs. Non-manual | 0.82 (0.41, 1.66) | 0.586 |
Unemployed vs. Non-manual | 1.07 (0.63, 1.80) | 0.806 |
Others vs. Non-manual | 1.01 (0.52, 1.99) | 0.971 |
Age (years) | ||
26–35 vs. 18–25 | 2.33 (1.22, 4.45) | 0.010 |
36–45 vs. 18–25 | 5.87 (2.53, 13.62) | <0.001 |
Number of pregnancy | ||
Second pregnancy vs. First pregnancy | 1.36 (0.85, 2.16) | 0.199 |
Trimester of pregnancy | ||
Mid-pregnancy vs. Early pregnancy | 0.83 (0.25, 2.79) | 0.769 |
Late-pregnancy vs. Early pregnancy | 4.25 (1.54, 11.71) | 0.005 |
Self-reported routine life during pregnancy | ||
Average vs. Regular | 0.88 (0.55, 1.39) | 0.576 |
Irregular vs. Regular | 0.84 (0.38, 1.88) | 0.674 |
Smoking during the pregnancy | ||
Yes vs. No | 0.89 (0.28, 2.88) | 0.847 |
TV viewing time per day (hours) | ||
2~4 vs. <2 | 0.93 (0.52, 1.68) | 0.813 |
>4 vs. <2 | 1.98 (1.02, 3.84) | 0.043 |
Computer using time per day (hours) | ||
2~4 vs. <2 | 1.21 (0.57, 2.56) | 0.616 |
>4 vs. <2 | 1.13 (0.60, 2.11) | 0.705 |
Mobile phone using time per day (hours) | ||
1~2 vs. <1 | 0.62 (0.35, 1.10) | 0.103 |
2~4 vs. <1 | 0.65 (0.36, 1.16) | 0.145 |
4~6 vs. <1 | 1.18 (0.58, 2.40) | 0.654 |
>6 vs. <1 | 0.53 (0.16, 1.75) | 0.299 |
Physical activity | ||
Sufficient vs. Insufficient | 1.46 (0.72, 2.93) | 0.292 |
Sleep duration during the pregnancy | ||
Insufficient sleeping duration vs. normal sleep duration | 1.61 (0.99, 2.63) | 0.057 |
Excessive sleep duration vs. normal sleep duration | 1.18 (0.67, 2.08) | 0.560 |
Sleep quality status | ||
Average vs. Good | 1.14 (0.70, 1.86) | 0.599 |
Poor vs. Good | 1.48 (0.80, 2.75) | 0.217 |
Eating breakfast every day | ||
Yes vs. No | 0.77 (0.41, 1.43) | 0.405 |
Number of meal per day during the pregnancy | ||
<3 times vs. 3 times | 1.11 (0.26, 4.73) | 0.885 |
4 times vs. 3 times | 0.82 (0.51, 1.32) | 0.407 |
≥5 times vs. 3 times | 1.08 (0.54, 2.17) | 0.823 |
Secondhand smoke exposure | ||
One to three per week vs. None | 0.62 (0.31, 1.23) | 0.170 |
Four to six days per week vs. None | 0.97 (0.41, 2.31) | 0.944 |
Every day vs. None | 1.04 (0.63, 1.70) | 0.886 |
BMI group by category of China | ||
Low vs. Normal | 0.46 (0.11, 1.94) | 0.291 |
Overweight vs. Normal | 1.03 (0.63, 1.68) | 0.904 |
Obesity vs. Normal | 1.97 (1.11, 3.52) | 0.022 |
BMI group by category of World Health Organization | ||
Low vs. Normal | 0.46 (0.11, 1.92) | 0.288 |
Overweight vs. Normal | 1.13 (0.70, 1.82) | 0.620 |
Obesity vs. Normal | 2.89 (1.42, 5.90) | 0.004 |
Anemia | ||
Yes vs. No | 0.69 (0.33, 1.44) | 0.319 |
Hypertension | ||
Yes vs. No | 4.40 (0.97, 19.99) | 0.055 |
Effect | OR a | 95% CI | p-Value | OR a | 95% CI | p-Value |
---|---|---|---|---|---|---|
Age (years) | ||||||
26–35 vs. 18–25 | 1.95 | (1.01, 3.78) | 0.048 | 1.90 | (0.98, 3.68) | 0.059 |
36–45 vs. 18–25 | 4.48 | (1.89, 10.67) | 0.001 | 4.29 | (1.80,10.25) | 0.001 |
Residence | ||||||
Urban area vs. Rural area | 1.88 | (0.88, 4.04) | 0.104 | 1.92 | (0.90, 4.13) | 0.093 |
Income | ||||||
Medium vs. Low | 0.99 | (0.53, 1.86) | 0.978 | 0.97 | (0.52, 1.81) | 0.917 |
High vs. Low | 1.35 | (0.73, 2.52) | 0.342 | 1.36 | (0.73, 2.52) | 0.338 |
Trimester of pregnancy | ||||||
Mid-pregnancy vs. Early pregnancy | 0.81 | (0.24, 2.75) | 0.732 | 0.80 | (0.24, 2.74) | 0.727 |
Late-pregnancy vs. Early pregnant | 4.03 | (1.42, 11.41) | 0.009 | 3.93 | (1.39, 11.09) | 0.010 |
TV viewing time per day (hours) | ||||||
2~4 vs. <2 | 0.87 | (0.48, 1.59) | 0.662 | 0.86 | (0.47, 1.56) | 0.612 |
>4 vs. <2 | 1.72 | (0.87, 3.40) | 0.118 | 1.81 | (0.92, 3.57) | 0.088 |
BMI group | BMI category of China | BMI category of WHO | ||||
Lean vs. Normal | 0.62 | (0.14, 2.66) | 0.515 | 0.65 | (0.15, 2.79) | 0.562 |
Overweight vs. Normal | 0.70 | (0.42, 1.17) | 0.177 | 0.76 | (0.46, 1.24) | 0.264 |
Obesity vs. Normal | 1.10 | (0.60, 2.02) | 0.755 | 1.67 | (0.80, 3.50) | 0.171 |
Hypertension | ||||||
Yes vs. No | 6.43 | (1.21, 34.16) | 0.029 | 6.75 | (1.29, 35.33) | 0.024 |
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Xu, X.; Liu, Y.; Liu, D.; Li, X.; Rao, Y.; Sharma, M.; Zhao, Y. Prevalence and Determinants of Gestational Diabetes Mellitus: A Cross-Sectional Study in China. Int. J. Environ. Res. Public Health 2017, 14, 1532. https://doi.org/10.3390/ijerph14121532
Xu X, Liu Y, Liu D, Li X, Rao Y, Sharma M, Zhao Y. Prevalence and Determinants of Gestational Diabetes Mellitus: A Cross-Sectional Study in China. International Journal of Environmental Research and Public Health. 2017; 14(12):1532. https://doi.org/10.3390/ijerph14121532
Chicago/Turabian StyleXu, Xianglong, Ying Liu, Dengyuan Liu, Xiaoming Li, Yunshuang Rao, Manoj Sharma, and Yong Zhao. 2017. "Prevalence and Determinants of Gestational Diabetes Mellitus: A Cross-Sectional Study in China" International Journal of Environmental Research and Public Health 14, no. 12: 1532. https://doi.org/10.3390/ijerph14121532