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Abstract：
BACKGROUND: Interpregnancy interval (IPI) is associated with the risk of GDM in a second pregnancy. However, an optimal IPI is still need to be determined based on the characteristics of the population. This study aimed to analyze the effect of interpregnancy interval (IPI) on the risk of gestational diabetes mellitus (GDM) in the Chinese population.
METHODS: We conducted a retrospective cohort study on female participants who had consecutive deliveries at Peking University Shenzhen Hospital from 2013 to 2021. The IPI was categorized into 7 groups and included into the multivariate logistic regression model with other confound factors. Analysis was also stratified based on age of first pregnancy, BMI, and history of GDM. Adjusted OR values (aOR) and 95% confidence intervals (CI) calculated. The regression coefficient of IPI months on GDM prediction risk was analyzed using a linear regression model.
RESULTS: A total of 2,392 participants were enrolled. The IPI of the GDM group was significantly greater than that of the non-GDM group (P < 0.05). Compared with the 18-24 months IPI category, participants with longer IPIs (24-36 months, 36-48 months, 48-60 months, and ≥ 60 months) had a higher risk of GDM (aOR:1.585, 2.381, 2.488, and 2.565; 95% CI: 1.021-2.462, 1.489-3.809, 1.441-4.298, and 1.294-5.087, respectively). For participants aged < 30 years or ≥ 30 years or without GDM history, all longer IPIs (≥ 36 months) were all significantly associated with the GDM risk in the second pregnancy (P < 0.05), while any shorter IPIs (< 18 months) was not significantly associated with GDM risk (P > 0.05). For participants with GDM history, IPI 12-18 months, 24-36 months, 36-48 months, and ≥ 60 months were all significantly associated with the GDM risk (aOR: 2.619, 3.747, 4.356, and 5.373; 95% CI: 1.074-6.386, 1.652-8.499, 1.724-11.005, and 1.078-26.793, respectively), and the slope value of linear regression (0.5161) was significantly higher compared to participants without a history of GDM (0.1891) (F = 284.168, P < 0.001).
CONCLUSIONS: Long IPI increases the risk of GDM in a second pregnancy, but this risk is independent of maternal age. The risk of developing GDM in a second pregnancy for women with GDM history is more significantly affected by IPI.
METHODS: We conducted a retrospective cohort study on female participants who had consecutive deliveries at Peking University Shenzhen Hospital from 2013 to 2021. The IPI was categorized into 7 groups and included into the multivariate logistic regression model with other confound factors. Analysis was also stratified based on age of first pregnancy, BMI, and history of GDM. Adjusted OR values (aOR) and 95% confidence intervals (CI) calculated. The regression coefficient of IPI months on GDM prediction risk was analyzed using a linear regression model.
RESULTS: A total of 2,392 participants were enrolled. The IPI of the GDM group was significantly greater than that of the non-GDM group (P < 0.05). Compared with the 18-24 months IPI category, participants with longer IPIs (24-36 months, 36-48 months, 48-60 months, and ≥ 60 months) had a higher risk of GDM (aOR:1.585, 2.381, 2.488, and 2.565; 95% CI: 1.021-2.462, 1.489-3.809, 1.441-4.298, and 1.294-5.087, respectively). For participants aged < 30 years or ≥ 30 years or without GDM history, all longer IPIs (≥ 36 months) were all significantly associated with the GDM risk in the second pregnancy (P < 0.05), while any shorter IPIs (< 18 months) was not significantly associated with GDM risk (P > 0.05). For participants with GDM history, IPI 12-18 months, 24-36 months, 36-48 months, and ≥ 60 months were all significantly associated with the GDM risk (aOR: 2.619, 3.747, 4.356, and 5.373; 95% CI: 1.074-6.386, 1.652-8.499, 1.724-11.005, and 1.078-26.793, respectively), and the slope value of linear regression (0.5161) was significantly higher compared to participants without a history of GDM (0.1891) (F = 284.168, P < 0.001).
CONCLUSIONS: Long IPI increases the risk of GDM in a second pregnancy, but this risk is independent of maternal age. The risk of developing GDM in a second pregnancy for women with GDM history is more significantly affected by IPI.
摘要：
背景：妊娠间期（IPI）与第二次妊娠中GDM的风险相关。然而,仍需要根据人群的特征确定最佳IPI.本研究旨在分析中国人群妊娠间隔时间(IPI)对妊娠期糖尿病(GDM)风险的影响。
方法：我们对2013年至2021年在北京大学深圳医院连续分娩的女性参与者进行了回顾性队列研究。将IPI分为7组，并与其他混杂因素一起纳入多变量逻辑回归模型。分析还根据首次怀孕的年龄进行了分层，BMI,GDM的历史计算调整后的OR值(aOR)和95%置信区间(CI)。采用线性回归模型分析IPI月对GDM预测风险的回归系数。
结果：共纳入2,392名参与者。GDM组的IPI显著大于非GDM组(P<0.05)。与18-24个月的IPI类别相比，IPI较长的参与者(24-36个月，36-48个月,48-60个月,和≥60个月）的GDM风险较高（aOR：1.585、2.381、2.488和2.565；95％CI：1.021-2.462、1.489-3.809、1.441-4.298和1.294-5.087）。对于年龄<30岁或≥30岁或无GDM病史的参与者，所有更长的IPI（≥36个月）均与第二次妊娠GDM风险显着相关（P<0.05），而任何较短的IPIs(<18个月)与GDM风险无显著相关性(P>0.05)。对于有GDM历史的参与者，IPI12-18个月，24-36个月,36-48个月,和≥60个月均与GDM风险显着相关（aOR：2.619、3.747、4.356和5.373；95％CI：1.074-6.386、1.652-8.499、1.724-11.005和1.078-26.793），与没有GDM病史的参与者相比，线性回归的斜率值（0.5161）明显更高（0.1891）（F=284.168，P<0.001）。
结论：长IPI会增加第二次妊娠GDM的风险，但这种风险与产妇年龄无关。有GDM病史的妇女在第二次怀孕中发生GDM的风险受IPI的影响更大。
方法：我们对2013年至2021年在北京大学深圳医院连续分娩的女性参与者进行了回顾性队列研究。将IPI分为7组，并与其他混杂因素一起纳入多变量逻辑回归模型。分析还根据首次怀孕的年龄进行了分层，BMI,GDM的历史计算调整后的OR值(aOR)和95%置信区间(CI)。采用线性回归模型分析IPI月对GDM预测风险的回归系数。
结果：共纳入2,392名参与者。GDM组的IPI显著大于非GDM组(P<0.05)。与18-24个月的IPI类别相比，IPI较长的参与者(24-36个月，36-48个月,48-60个月,和≥60个月）的GDM风险较高（aOR：1.585、2.381、2.488和2.565；95％CI：1.021-2.462、1.489-3.809、1.441-4.298和1.294-5.087）。对于年龄<30岁或≥30岁或无GDM病史的参与者，所有更长的IPI（≥36个月）均与第二次妊娠GDM风险显着相关（P<0.05），而任何较短的IPIs(<18个月)与GDM风险无显著相关性(P>0.05)。对于有GDM历史的参与者，IPI12-18个月，24-36个月,36-48个月,和≥60个月均与GDM风险显着相关（aOR：2.619、3.747、4.356和5.373；95％CI：1.074-6.386、1.652-8.499、1.724-11.005和1.078-26.793），与没有GDM病史的参与者相比，线性回归的斜率值（0.5161）明显更高（0.1891）（F=284.168，P<0.001）。
结论：长IPI会增加第二次妊娠GDM的风险，但这种风险与产妇年龄无关。有GDM病史的妇女在第二次怀孕中发生GDM的风险受IPI的影响更大。
