The risk factors for gestational diabetes mellitus and its impact on pregnancy outcomes：A multicenter retrospective cohort study

Background Gestational diabetes mellitus (GDM) is a common pregnancy complication, associated with adverse health outcomes for both the mother and the offspring. The study was aimed to identify the risk factors for GDM and its impact on pregnancy outcomes. Methods A multicenter retrospective cohort study was conducted to analyze the involving 41,254 pregnant women delivered in Hangzhou, China, from May 2014 to April 2024. Of these, 5,545 cases were GDM and 35,709 cases were non-GDM. Collection and analysis of electronic medical record front page data was performed. Univariate logistic regression was used to assess pregnancy outcomes, and significant variables were incorporated into multivariate binary logistic regression for further analysis by adjusted odds ratio (aOR) and 95% confidence interval (CIs). Results Multivariate binary logistic regression analysis identified maternal age, maternal weight and gravidity as independent risk factors for GDM, while parity was protective factor for GDM. For pregnancy outcomes, GDM was significantly associated with gestational hypertension (GH) (aOR = 1.796, 95%CI:1.573–2.051), preeclampsia (PE) (aOR = 1.947, 95%CI:1.594–2.379), dyslipidemia (aOR = 1.428, 95%CI:1.258–1.620), polyhydramnios (aOR = 1.530, 95%CI:1.123–2.084), preterm premature rupture of membranes (PPROM) (aOR = 1.497, 95%CI:1.093–2.050), preterm birth (aOR = 1.212, 95%CI:1.026–1.432), increased hospital day (aOR = 1.404, 95%CI:1.254–1.571), and macrosomia (aOR = 1.607, 95%CI:1.396–1.850), all P <0.05. Conclusion Maternal age, maternal weight and gravidity were independent risk factors for GDM, and parity was protective factor for GDM. GDM was significantly associated with GH, PE, dyslipidemia, polyhydramnios, PPROM, preterm birth, increased hospital day and macrosomia.