Association of gestational diabetes mellitus with adverse pregnancy outcomes: our experience and meta-analysis
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REVIEW ARTICLE
Association of gestational diabetes mellitus with adverse pregnancy outcomes: our experience and meta-analysis Yi Shen 1 & Yulong Jia 1 & Jie Zhou 1 & Xiao-Yan Cheng 2 & Hai-Yan Huang 3 & Cheng-Qing Sun 1 & Lu-Lu Fan 1 & Jian Chen 4 & Li-Ying Jiang 5 Received: 30 March 2019 / Accepted: 20 January 2020 # Research Society for Study of Diabetes in India 2020
Abstract Aims/introduction The incidence of gestational diabetes mellitus (GDM) has increased recently worldwide with a subsequent occurrence of the associated adverse pregnancy outcomes. The objective of this study was to estimate the association between women with GDM and adverse pregnancy outcomes based on a cohort study and an integrated meta-analysis. Materials and methods A retrospective cohort of 15,097 pregnant women (1718 GDM with 13,379 non-GDM controls) who delivered at two affiliated medical centers of Nantong University from Jan. 1, 2014 to Sep. 30, 2015, was conducted. Then, a meta-analysis was performed to explore and compare adverse pregnancy outcomes between GDM and non-GDM women. Results In our cohort study, women with GDM were at significantly greater risk for cesarean section [crude relative risk (RR): 2.20, 95% confidence interval (CI): 1.97–2.44], macrosomia (crude RR: 2.36, 95% CI: 2.04–2.74) and large for gestational age (LGA) (crude RR: 2.03, 95% CI: 1.81–2.27), and a lower risk of low birth weight (LBW) (crude RR: 0.64, 95% CI: 0.47–0.86) and small for gestational age (SGA) (crude RR: 0.60, 95% CI: 0.45–0.80) than GDM-free women. However, the preterm birth incidence was not associated with GDM [crude RR: 1.08, 95% CI: 0.91–1.29]. Similarly, the meta-analysis including our cohort study also showed a significant association between GDM and preterm birth (pooled RR: 1.36, 95% CI: 1.26–1.48). Conclusions Women with GDM still have an increased incidence of adverse pregnancy outcomes, which indicated that early prevention and clinical treatment of disease should be enhanced. Keywords Cohort study . Gestational diabetes mellitus . Meta-analysis . Pregnancy outcomes
Yi Shen and Yulong Jia contributed equally to this work. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s13410-020-00802-x) contains supplementary material, which is available to authorized users. * Li-Ying Jiang [email protected] 1
Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Nantong, China
2
Department of Obstetrics, Nantong Maternal and Children Health Care Service Hospital, Nantong University, Nantong, China
3
Department of Obstetrics and Gynecology, Affiliated Hospital of Nantong University, Nantong University, Nantong, China
4
Scientific Educational Section, Nantong Maternal and Children Health Care Service Hospital, Nantong University, Nantong, China
5
Shanghai Key Laboratory for Molecular Imaging, Shanghai University of Medicine & Health Sciences, No 279 Zhouzhu Highway, Pudong New Area, Shanghai 201318, China
Introduction Gestational diabetes mellitus (G
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