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Objective To assess whether a lifestyle intervention starting in early pregnancy can reduce the incidence of gestational diabetes mellitus (GDM) among Chinese women with high risk factors. Methods Between January 2020 and September 2021, women at gestational age of 6-15 weeks with high risk factors [body mass index (BMI) of 24-35 kg/m2 or a family history of diabetes] in 4 urban districts and 3 suburban districts of Tianjin were recruited as an intervention cohort. During the same period, the high-risk pregnant women who received routine maternal management from two of the above districts, one in urban and the other in suburban district, were retrospectively enrolled as a control cohort through the hospital system information. Women in the intervention cohort received a combination of online and offline lifestyle intervention (nutrition, exercise, and weight control). At the baseline survey, information including age, family history of diabetes, gestational age, and fasting plasma glucose (FPG) level were collected at the baseline survey. The height and body weight were recorded, and BMI was calculated. All pregnant women underwent two-step GDM screening at gestational age of 24-28 weeks. The comparison between the two cohorts was performed using the t test or the χ2 test. Logistic regression model was used to evaluate the effect of lifestyle intervention on GDM incidence. Results Finally, 106 and 2 348 patients were included in the intervention and control cohorts, respectively. There were statistically significant differences between the two cohorts in gestational age, family history of diabetes proportion, gestational age and FPG level at the baseline survey (P<0.05). At gestational age of 24-28 weeks, the incidence of GDM in the intervention and control cohorts was 19.8% (21/106) and 29.6% (696/2 348), respectively (P=0.029), with a relative risk reduction of 33%. Multivariate logistic regression analysis showed that the risk of GDM was significantly lower in the intervention cohort than that in the control cohort, with an OR and 95% confidence interval of 0.41 (0.24-0.69). Conclusion Lifestyle intervention (nutrition, exercise, and weight control) starting in early pregnancy can reduce the incidence of GDM in pregnant women with high risk factors. [ABSTRACT FROM AUTHOR]

Objective To evaluate the effects of postpartum diet and lifestyle intervention on gestational diabetes (GDM) women with different genetic risk scores (GRS). Methods Based on an established randomized controlled trial (RCT) evaluating the effects of a postpartum diet and lifestyle intervention between August 2009 and September 2013, women with previous GDM and non-diabetes postpartum were recruited. Information at baseline and follow-up survey after 1-year intervention were collected, including fasting blood glucose (FPG), 2-hour blood glucose (2hPG), total cholesterol (TC), body fat, waist circumference, dietary fiber intake>20 g/d, and exercise> 30 min/d and other indicators. The height and body weight were recorded, and the body mass index (BMI) was calculated. After 1-year intervention, percentage reduction in initial weight, and changes in 2hPG, TC, weight, BMI, waist circumference and body fat percentage were calculated. We detected 11 postpartum type 2 diabetes mellitus (T2DM)-related single nucleotide polymorphisms (SNP) which were previously validated, and calculated the individual′s comprehensive GRS. Patients were divided into low genetic risk group (GRS<10.00) and high genetic risk group (GRS≥10.00) according to the median of GRS. In the low and high genetic risk groups, patients were divided into lifestyle intervention group and control group respectively. The t test or χ2 test were used to compare the indicators between the intervention and control group. Results A total of 675 patients were enrolled in the study, including 292 patients with low genetic risk (142 in the intervention group and 150 in the control group), and 383 patients with high genetic risk (188 in the intervention group and 195 in the control group), respectively. Among patients with low genetic risk, compared with control group, patients in the intervention group had a higher rate of dietary fiber intake>20 g/d (P=0.037), a lower rate of abnormal blood glucose (P=0.012), and better changed 2hPG and TC (both P<0.05). Among patients with high genetic risk, compared with control group, patients in the intervention group had a higher rate of exercise>30 min/d (P=0.003), better changed fasting insulin (P=0.038), and the changes in weight, percentage in weight change BMI, waist circumference and body fat percentage were larger (all P<0.05). Conclusions The postpartum diet and lifestyle intervention were relatively effective for GDM patients with different genetic risks. GDM patients with low genetic risk had increased dietary fiber intake, improved blood glucose and lipid levels, and lower risk of abnormal blood glucose. GDM patients with high genetic risk had larger changes in weight, BMI, waist circumference and body fat percentage, and better insulin improvement after comprehensive intervention. [ABSTRACT FROM AUTHOR]

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Objective:To understand the changing trend of the birth weight of live births in Tianjin city during 2008-2015 and to provide the basis for the control of birth weight in a reasonable range. Methods: Selection of mothers living in the six areas of Tianjin city(Heping District, Hedong District, Hexi District, Nankai District, Hebei District, Hongqiao District), who delivered between October 1, 2007 to September 30, 2015 of pregnant full 28 weeks of live births as the research object, describe the changing trend of birth weight, the incidence of low birth weight and large infant. Results:Between 2008 and 2015, there were significant differences in the average birth weight, low birth weight rate and the occurrence of the large infant in the urban areas of Tianjin in different years (F=17.306, P<0.001; χ2 =72.684, P<0.001; χ2 =92.818, P<0.001). The average birth weight and the incidence of large infant in the urban area of Tianjin in 2009 was the highest, 2010 decreased year by year, a slight increase in 2015. The incidence of low birth weight was lowest in 2009, 2010 increased year by year. Conclusions:Tianjin city birth weight has been decreased from 2008 to 2015, but still higher than the reference value recommended by the World Health Organization, birth weight control is still key point of perinatal health care in Tianjin city. [ABSTRACT FROM AUTHOR]

Objective: We retrospectively analyze the potential risk factors and perinatal outcomes of the pregnant women with gestational diabetes mellitus (GDM), in order to provide evidence for prevention and treatment. Methods: Totally there were 47, 118 pregnant women who accepted diabetes detection during pregnancy in Tianjin region from January 2014 to June 2014, including 3 650 women with gestational diabetes mellitus (GDM group) and 43 468 women without GDM (non-GDM group). Related variables of the two groups were compared by using statistical methods. Results: Significant difference was found between GDM group and non-GDM group in age, education, and pre-pregnant overweight/obesity status (P<0.01). Logistic regression analysis showed that old age, city registration, high education, large pre-pregnancy BMI and multiple gestations were risk factors for GDM. Women with GDM have significantly high incidence of cesarean delivery, premature delivery, pregnancy-induced hypertension, macrosomia, low birth weight than women with non-GDM (P<0.01). Conclusions: Varieties of factors would affect the incidence of GDM. More attention should be paid on risk factors. Strengthening management of pregnant women with GDM will reduce the incidence of maternal and neonatal complications. [ABSTRACT FROM AUTHOR]