The risk factors for gestational diabetes mellitus in China : a systematic review

Abstract

Background: Gestational diabetes mellitus (GDM) is defined as glucose intolerance that is first detected during the pregnancy and is associated with a probable resolution after the end of the pregnancy. Asians adopting a modern lifestyle have a higher risk of diabetes than their white counterparts living in high-income countries. Asian ethnicity is an independent risk factor for GDM, which is associated with a 2-fold increased risk of diabetes. China is one of the Asian countries with large number of people and health burden with diabetes, meanwhile GDM is associated with a substantially increased risk of it that often onset of disease in early middle age. Therefore, Studying and determined the risk factors or potential risk factors in China population can assist with GDM early screening and diagnosis as well as helpful for further design a prevention programme. This systematic review assessed the risk factors of GDM in China. Methods and Results: Four electronic databases were searched with both English language and Chinese language; PubMed, Scopus, the Cochrane Library and China Journal Net. Each combination with terms including “gestational diabetes mellitus” or “gestational diabetes”, “diabetes”, “risk factors”, “China” and “pregnancy” were searched. Eligible articles were defined GDM and clear description of GDM diagnostic criteria, with inclusion and exclusion criteria, and clear conclusion about the risk factors under the comprehensive statistical methods. The reporting quality within each study including observational studies and randomization placebo-control study were assessed. This systematic review conducted by following the PRISMA guideline (Table S1 and Figure S1). The articles reviewed and identified 275 sole records. After selection step by step, thirteen articles with full text available were included for final systematic review. Information regarding inclusion and exclusion criteria, screening methods, clear GDM diagnostic criteria, statistical analysis for risk factors and clear conclusion were obtained from the north of China to the south of China: Beijing (n=1), Tianjin (n=4), Jiangsu (n=1), Shanghai (n=1), Guangdong (n=3),Guangxi (n=1), Hong Kong (n=1), other (n=1, which data collected from 18 cities in China). Most studies illustrated and identified the common risk factors including advanced maternal age, higher pre-pregnancy BMI, family history of diabetes and hypertension, however, some uncommon also being proved that being risk factors toward GDM including Han-nationality ; residency in south compare to in north, history of Recurrent Vulvovaginal Candidiasis(RVVC) and history of spontaneous abortion ; short stature and smoking in pregnancy ; and parents with malignant tumor.