1. Comparison Between GDM Group and NGT Group
According to the diagnostic criteria for GDM proposed by IADPSG in 2010 [1], the cohort comprised 1804 women, stratified into 317(17.6%)GDM subjects and 1487 NGT subjects. Significant differences were observed in age, pre-pregnancy BMI, and previous obstetric history between the two groups. Except HOMA-%S, all metabolic parameter in GDM group in the 1st trimester were higher than those in NGT group (p < 0.05). FBG in NGT group was lower in 2nd trimester than 1st trimester, whereas comparable in GDM group. After an oral glucose load, the peak of plasma insulin concentrations in GDM group occurred somewhat later than those in NGT group, with higher HOMA-IR, HOMA-B, and lower HOMA-%S. In the 3nd trimester, except for TG, the other three lipid profiles, GWG and delivery weeks were much lower in GDM group (Table 1).
Table 1
Characteristics and pregnancy outcomes in GDM group VS NGT group
Characteristic | NGT group(n = 1487) | GDM group(n = 317) | P value |
General | |
Age(years) | 28.7 ± 4.0 | 30.4 ± 4.3 | < 0.001 |
Per-pregnancy BMI(kg/m2) | 21.6 ± 5.5 | 23.1 ± 3.3 | < 0.001 |
History of hypothyroidism | 12.2(181) | 14.5(46) | 0.254 |
Interval between the last childbirth | 23.1(343) | 35.3(112) | < 0.001 |
Gravidity | 34.6(514) | 43.2(137) | < 0.001 |
Parity | 41.7(620) | 53.(168) | < 0.0001 |
History of macrosomia | 1.8(27) | 4.7(15) | 0.002 |
History of caesarean | 15.9(232) | 26.8(85) | < 0.0001 |
6-16weeks of pregnancy | |
FPG(mmol/l) | 4.7(4.5,4.9)a0 | 4.9(4.7,5.2)b0 | < 0.001 |
FINS(uU/ml) | 6.2(4.5,8.5)a1 | 7.9(5.6,10.7)b1 | < 0.001 |
HOMA-IR | 1.3(0.9,1.8)a2 | 1.7(1.2,2.4)b2 | < 0.001 |
HOMA-B | 102.8(77.1,137.9)a3 | 111.3(80.2,154.9)b3 | 0.003 |
HOMA-%S | 76.6(54.9,107.5)a4 | 57.5(41.2,83.5)b4 | < 0.001 |
TG(mmol/l) | 1.2(1.0,1.6)e0 | 1.4(1.1,1.9)f0 | < 0.001 |
TC(mmol/l) | 4.2(3.8,4.7)e1 | 4.4(3.9,4.9)f1 | < 0.001 |
HDL-C(mmol/l) | 1.5(1.3,1.7)e2 | 1.4(1.3,1.7)f2 | 0.309 |
LDL-C(mmol/l) | 2.2(1.8,2.6)e3 | 2.4(2.0,2.8)f3 | < 0.001 |
22–28 weeks of pregnancy | |
G0min(mmol/l) | 4.5(4.3,4.7) | 5.0(4.5,5.2) | < 0.001 |
G60min(mmol/l) | 7.3(6.3,8.3) | 10.1(9.1,10.7) | < 0.001 |
G120min(mmol/l) | 6.2(5.5,7.0) | 8.5(7.3,9.2) | < 0.001 |
I0min(uU/ml) | 7.3(5.6,9.8) | 9.6(7.0,13.7) | < 0.001 |
I60min(uU/ml) | 52.4(36.8,74.0)c1 | 64.6(46.7,100.0)d1 | < 0.001 |
I120min(uU/ml) | 42.2(29.0,60.9)c2 | 70.0(44.9,98.5)d2 | < 0.001 |
HOMA-IR | 1.4(1.1,2.0) | 2.2(1.5,3.2) | < 0.001 |
HOMA-B | 158.2(122.2,209.7) | 142.8(109.6,192.2) | < 0.001 |
HOMA-%S | 69.2(50.1,91.8) | 47.1(32.5,68.0) | < 0.001 |
30-42weeks of pregnancy | |
FPG(mmol/l) | 4.5(4.3,4.7) | 4.9(4.5,5.1) | < 0.001 |
TG(mmol/l) | 3.04(2.46,3.87) | 3.4(2.7,4.2) | < 0.001 |
TC(mmol/l) | 6.2(5.6,7.0) | 6.0(5.3,6.8) | 0.002 |
HDL-C(mmol/l) | 1.6(1.4,1.8) | 1.5(1.3,1.7) | < 0.001 |
LDL-C(mmol/l) | 3.4(2.8,4.1) | 3.2(2.6,3.9) | < 0.001 |
Maternal pregnancy outcomes | |
GWG(kg) | 13.3 ± 4.4 | 11.08 ± 4.3 | < 0.001 |
Gestational age(days) | 273.5 ± 12.6 | 272.0 ± 8.1 | 0.037 |
Gravity ICP | 1.5(22) | 2.8(9) | 0.091 |
Gestational Hypertension /Preeclampsia | 3.1(46) | 4.7(15) | 0.143 |
Chorionitis | 1.5(22) | 1.9(6) | 0.589 |
PPROM | 19.4(288) | 23.3(74) | 0.128 |
Primary cesarean section | 26.8(398) | 26.8(85) | 0.986 |
Postpartum Hemorrhage | 2.0(29) | 3.5(11) | 0.095 |
Perinatal outcomes | |
Neonatal jaundice | 14.8(220) | 24.6(78) | 0.001 |
LGA | 14.3(213) | 23.0(73) | 0.001 |
SGA | 3.3(49) | 1.0(3) | 0.038 |
Infant of low-birth weight | 3.9(49) | 2.4(7) | 0.313 |
Macrosomia | 3.7(53) | 9.7(30) | 0.001 |
Premature | 4.2(62) | 5.0(16) | 0.485 |
Neonatal asphyxia | 2.3(34) | 4.1(13) | 0.066 |
Apgar 1min < 7 | 0.8(12) | 3.8(12) | 0.001 |
NICU admission | 4.3(64) | 7.6(24) | 0.014 |
Categorical variables were presented as %(n); continuous variables were presented as mean ±SD if normally distributed and as median (interquartile rang) if not normally distributed . Differences were considered significant at p<0.005
Gravidity(≥2times), Parity(≥1times), Interval between the last childbirth(≥6years), Macrosomia (birth weight > 4kg), Infant of low-birth weight (birth weight <2.5kg), Premature delivery (gestational age < 37 weeks), LGA (defined as birth weight >P 90 according to standardized birth charts adjusted for the sex of the baby and parity), SGA (defined as birth weight <P10 according to standardized birth charts adjusted for the sex of the baby and parity).
There were differences between indexes of a0-4 and b1-4 at 6-16 weeks of pregnancy and those at 22-28 weeks of pregnancy, p<0.05;
Comparison between c1 and c2 showed differences, p<0.001; Comparison between d1 and d2 showed no difference, p=0.726;
There were differences between indexes of e0-3 and f0-3 at 22-28 weeks of pregnancy and those at 30-42 weeks of pregnancy, p<0.05
Comparison of GDM group with NGT group revealed significantly higher rates of LGA, macrosomia, neonatal jaundice, 1min Apgar score and NICU admission (p < 0.05), but comparable rate of SGA, premature delivery and perinatal asphyxia (p > 0.05) (Table 1).
2. Subgroups of GDM and NGT Comparison
Participants were categorized into underweight group (BMI < 18.5kg/m2), normal weight group (18.5kg/m2 ≤ BMI < 25.0kg/m2) and overweight group (BMI ≥ 25.0kg/m2) based on pre-pregnancy BMI [11].
Calculation of HOMA-IR indices in early pregnancy involved ROC curve analysis to determine the HOMA-IR cut-off value. The ROC curve in Fig. 1 showed a maximum area of 0.65 (sensitivity 0.57, specificity 0.67, p < 0.001), with a cut-off value at 1.75. By combining HOMA-IR cut-off value with pre-pregnancy BMI, NGT and GDM subjects were grouped into six subgroups each, with details of each subgroup provided in Table 2 (excluding subgroups with HOMA-IR < 1.75/BMI ≥ 25kg/m2 and HOMA-IR > 1.75/BMI < 18.5kg/m2).
Table 2 Subgroups of GDM and NGT based on HOMA-IR and BMI in early pregnancy
HOMA-IR BMI(kg/m2) | HOMA-IR ≥ 1.75 | HOMA-IR < 1.75 |
< 18.5 | ≥ 18.5 < 25.0 | ≥ 25.0 | < 18.5 | ≥ 18.5 < 25.0 | ≥ 25.0 |
NGT subgroups (n) | - | E | G | A | C | - |
26 | 256 | 125 | 188 | 836 | 56 |
GDM subgroups (n) | - | F | H | B | D | - |
1 | 74 | 83 | 15 | 120 | 24 |
First trimester, only FPG was different between subgroups G and H, other variables including age, FPG, FINS, HOMA-IR, HOMA-B, HOMA-%S, and lipid profiles of other subgroups were similar. At the time of OGTT, the peak of plasma insulin concentrations were out of sync with the peak of plasma glucose in GDM subgroups. Except for subgroups A and B, HOMA-IR, HOMA-B, and HOMA-%S of subgroups D, F and H differed from subgroups C, E and G (refer to Table 3). In the third trimester, FPG in GDM subgroups exhibited differences from the control subgroups.
Table 3 Characteristics and pregnancy outcomes in GDM subgroups vs NGT subgroups stratified by HOMA-IR and BMI in early pregnancy
Characteristic
|
Group A(n = 188)
|
Group B
(n = 15)
|
P value
|
Group C(n = 836)
|
Group D(n = 120)
|
P value
|
Group E
(n = 256)
|
Group F
(n = 74)
|
P value
|
Group G
(n = 125)
|
Group H
(n = 83)
|
P value
|
General
|
Age(years)
|
27.2 ± 3.7
|
30.2 ± 5.4
|
1.00
|
29.2 ± 3.9
|
30.5 ± 4.5
|
0.21
|
28.1 ± 3.9
|
29.7 ± 4.2
|
0.10
|
28.6 ± 4.2
|
30.4 ± 4.1
|
0.11
|
Per-pregnancy
BMI(kg/m2)
|
17.4 ± 1.0
|
17.3 ± 1.1
|
1.00
|
21.1 ± 1.6
|
21.1 ± 1.6
|
1.00
|
22.0 ± 1.8
|
22.2 ± 1.7
|
1.00
|
27.3 ± 2.6
|
26.9 ± 2.0
|
1.00
|
History of hypothyroidism
|
10.6(20)
|
0.0(0)
|
0.18
|
12.3(103)
|
13.3(16)
|
0.75
|
12.9(33)
|
12.2(9)
|
0.87
|
12.8(16)
|
24.1(20)
|
0.03
|
Interval between the last childbirth
|
16.0(30)
|
20.0(3)
|
0.68
|
26.0(217)
|
38.3(46)
|
0.005
|
17.6(45)
|
27.0(20)
|
0.07
|
26.4(33)
|
24.7(29)
|
0.19
|
Gravidity
|
26.6(50)
|
40.0(6)
|
0.26
|
37.1(310)
|
45.0(54)
|
0.01
|
28.5(73)
|
35.1(26)
|
0.27
|
41.6(52)
|
39.2(29)
|
0.74
|
Parity
|
27.1(51)
|
40.0(6)
|
0.29
|
45.2(378)
|
58.3(70)
|
0.007
|
38.7(99)
|
41.9(31)
|
0.62
|
47.2(59)
|
51.8(43)
|
0.52
|
History of macrosomia
|
1.1(2)
|
0.0(0)
|
1.0
|
1.4(12)
|
4.2(5)
|
0.34
|
2.3(6)
|
6.8(5)
|
0.06
|
4.0(5)
|
3.6(3)
|
1.00
|
History of caesarean
|
9.0(17)
|
20.0(3)
|
0.36
|
16.5(138)
|
39.2(35)
|
< 0.001
|
16.0(41)
|
23.0(17)
|
0.16
|
23.3(29)
|
26.5(22)
|
0.59
|
6-16weeks of pregnancy
|
G0min(mmol/l)
|
4.7
(4.5,4.8)
|
4.7
(4.6,5.0)
|
1.00
|
4.7
(4.5,4.9)
|
4.8
(4.5,5.0)
|
0.30
|
5.0
(4.8,5.2)
|
5.1
(4.8,5.4)
|
1.00
|
4.9
(4.7,5.0)
|
5.0
(4.9,5.3)
|
0.01
|
I0min(uU/ml)
|
4.5
(3.4,5.8)
|
5.1
(3.8,6.1)
|
1.00
|
5.5
(4.2,6.6)
|
5.5
(4.3,6.6)
|
1.00
|
10.0
(8.8,11.9)
|
9.6
(8.5,12.4)
|
1.00
|
11.1
(9.5,14.1)
|
11.6
(9.8,14.2)
|
1.00
|
HOMA-IR
|
0.9
(0.7,1.3)
|
1.1
(0.8,1.3)
|
1.00
|
1.1
(0.9,1.4)
|
1.2
(0.9,1.4)
|
1.00
|
2.2
(2.0,2.6)
|
2.3
(1.9,2.8)
|
1.00
|
2.4
(2.1,3.0)
|
2.7
(2.2,3.2)
|
1.00
|
HOMA-B
|
78.3
(63.1,99.6)
|
69.4(52.5,106.3)
|
1.00
|
90.9
(71.7,114.5)
|
81.1
(65.2,110.5)
|
1.00
|
142.6
(114.7,179.2)
|
129.7
(102.4,158.9)
|
1.00
|
176.6
(137.0,217.4)
|
162.4
(127.8,190.4)
|
1.00
|
HOMA-%S
|
107.4(80.1,142.4)
|
90.6
(75.6,118.4)
|
1.00
|
87.8
(73.3,118.0)
|
84.0
(72.4,112.7)
|
1.00
|
45.8
(39.2,51.3)
|
43.9
(35.6,53.9)
|
1.00
|
42.6
(33.6,48.5)
|
37.8
(31.7,45.5)
|
1.00
|
TG(mmol/l)
|
1.1
(0.9,1.3)
|
1.2
(1.0,1.3)
|
1.00
|
1.2
(0.9,1.5)
|
1.3
(1.0,1.7)
|
1.00
|
1.3
(1.0,1.7)
|
1.5
(1.2,2.0)
|
0.08
|
1.6
(1.2,2.0)
|
1.7
(1.3,2.2)
|
1.00
|
TC(mmol/l)
|
4.0
(3.6,4.5)
|
4.4
(3.8,5.4)
|
0.76
|
4.2
(3.8,4.7)
|
4.2
(3.8,4.7)
|
1.00
|
4.2
(3.9,4.7)
|
4.4
(4.0,4.9)
|
1.00
|
4.4
(3.9,5.0)
|
4.6
(4.1,5.1)
|
1.00
|
HDL-C(mmol/l)
|
1.5
(1.3,1.7)
|
1.6
(1.3,2.0)
|
1.00
|
1.5
(1.3,1.7)
|
1.6
(1.3,1.7)
|
1.00
|
1.4
(1.3,1.6)
|
1.4
(1.3,1.6)
|
1.00
|
1.4
(1.2,1.6)
|
1.3
(1.2,1.5)
|
1.00
|
LDL-C(mmol/l)
|
1.9
(1.7,2.3)
|
2.2
(1.8,2.8)
|
1.00
|
2.2
(1.8,2.5)
|
2.2
(1.8,2.5)
|
1.00
|
2.3
(1.9,2.6)
|
2.5
(2.2,2.8)
|
0.20
|
2.5
(2.2,2.8)
|
2.6
(2.3,3.2)
|
0.88
|
22–28 weeks of pregnancy
|
G0min(mmol/l)
|
4.4
(4.2,4.6)
|
4.7
(4.5,5.0)
|
0.01
|
4.5
(4.2,4.6)
|
4.7
(4.3,5.1)
|
< 0.001
|
4.5
(4.3,4.8)
|
5.1
(4.6,5.2)
|
< 0.001
|
4.6
(4.4,4.8)
|
5.1
(4.9,5.4)
|
< 0.001
|
G60min(mmol/l)
|
6.9
(5.9,8.1)
|
9.9
(8.6,10.6)
|
< 0.001
|
7.2
(6.2,8.1)
|
10.0
(8.9,10.9)
|
< 0.001
|
7.6
(6.7,8.5)
|
10.3
(9.1,10.7)
|
< 0.001
|
8.0
(6.8,8.9)
|
10.2
(9.1,10.8)
|
< 0.001
|
G120min(mmol/l)
|
6.2
(5.4,6.9)
|
8.2
(7.3,9.2)
|
< 0.001
|
6.2
(5.4,6.9)
|
8.6
(7.6,9.3)
|
< 0.001
|
6.4
(5.7,7.0)
|
8.3
(6.8,9.2)
|
< 0.001
|
6.5
(5.9,7.2)
|
8.2
(7.3,9.2)
|
< 0.001
|
I0min(uU/ml)
|
5.9
(4.8,7.1)
|
7.6
(5.7,11.5)
|
0.43
|
7.0
(5.3,8.8)
|
7.6
(5.8,9.4)
|
0.81
|
9.2
(6.9,12.3)
|
10.9
(8.0,16.1)
|
0.52
|
12.0
(9.0,15.0)
|
14.1
(10.9,16.8)
|
0.72
|
I60min(uU/ml)
|
41.9a1(31.5,56.5)
|
61.3b1(37.8,79.9)
|
0.64
|
49.7c1(34.3,67.5)
|
56.0d1
(39.1,75.0)
|
1.00
|
65.2e1
(46.3,94.1)
|
74.4f1
(53.0,127.1)
|
1.00
|
69.9g1
(52.6,102.8)
|
90.0h1
(58.7,129.5)
|
1.00
|
I120min(uU/ml)
|
37.0a2(25.3,49.4)
|
72.4b2(41.0,109.8)
|
0.002
|
39.4c2(27.8,56.6)
|
52.6d2
(42.2,76.9)
|
< 0.001
|
51.8e2
(35.9,78.0)
|
74.0f2
(48.0,115.8)
|
0.001
|
59.4g2
(43.3,82.3)
|
81.9h2
(56.6,125.7)
|
0.002
|
HOMA-IR
|
1.1
(0.9,1.4)
|
1.6
(1.2,2.3)
|
0.16
|
1.4
(1.0,1.8)
|
1.6
(1.2,2.1)
|
0.03
|
1.9
(1.4,2.5)
|
2.4
(1.6,3.5)
|
0.03
|
2.4
(1.9,3.1)
|
3.2
(2.4,3.9)
|
0.002
|
HOMA-B
|
133.5(105.2,178.4)
|
126.8(94.2,160.5)
|
1.00
|
150.1(115.9,195.3)
|
132.0
(101.3,177.9)
|
0.002
|
176.2
(140.3,247.6)
|
154.4
(117.4,198.2)
|
0.04
|
211.8
(162.3,285.1)
|
170.2
(134.0,214.2)
|
0.01
|
HOMA-%S
|
87.4
(70.6,110.6)
|
62.3
(43.2,86.5)
|
0.16
|
73.0
(56.5,98.5)
|
64.2
(48.3,87.0)
|
0.03
|
53.2
(40.0,72.0)
|
41.0
(28.3,62.0)
|
0.03
|
42.2
(31.8,53.9)
|
31.7
(25.8,41.0)
|
0.002
|
30-42weeks of pregnancy
|
FPG(mmol/l)
|
4.4
(4.2,4.6)
|
4.8
(4.4,5.1)
|
0.008
|
4.5
(4.3,4.7)
|
4.7
(4.4,5.1)
|
< 0.001
|
4.6
(4.4,4.8)
|
4.9
(4.5,5.1)
|
0.001
|
4.6
(4.4,45.0)
|
5.0
(4.7,5.3)
|
< 0.001
|
TG(mmol/l)
|
2.9
(2.4,3.7)
|
3.8
(2.9,4.1)
|
1.00
|
3.1
(2.4,3.9)
|
3.0
(2.5,3.9)
|
1.00
|
3.0
(2.5,3.9)
|
3.5
(3.0,4.4)
|
0.004
|
3.2
(2.6,4.2)
|
3.6
(3.0,4.6)
|
0.43
|
TC(mmol/l)
|
6.5
(5.8,7.3)
|
6.2
(5.8,7.4)
|
1.00
|
6.3
(5.7,7.0)
|
6.4
(5.4,6.9)
|
1.00
|
6.1
(5.4,7.0)
|
6.1
(5.3,6.9)
|
1.00
|
5.7
(5.1,6.7)
|
5.6
(5.0,6.6)
|
1.00
|
HDL-C(mmol/l)
|
1.6
(1.5,1.9)
|
1.6
(1.3,1.8)
|
1.00
|
1.6
(1.4,1.8)
|
1.6
(1.4,1.9)
|
1.00
|
1.6
(1.4,1.8)
|
1.5
(1.3,1.7)
|
0.40
|
1.5
(1.3,1.8)
|
1.4
(1.3,1.7)
|
1.00
|
LDL-C(mmol/l)
|
3.7
(3.1,4.4)
|
3.2
(2.7,3.9)
|
1.00
|
3.4
(2.9,4.0)
|
3.4
(2.7,4.0)
|
1.00
|
3.3
(2.7,4.0)
|
3.1
(2.45,4.0)
|
1.00
|
3.2
(2.5,3.9)
|
3.0
(2.5,3.6)
|
1.00
|
Maternal pregnancy outcomes
|
GWG(kg)
|
13.8 ± 3.6
|
11.8 ± 2.9
|
1.00
|
13.5 ± 4.2
|
11.8 ± 3.6
|
0.001
|
13.1 ± 4.5
|
12.1 ± 4.0
|
1.00
|
11.4 ± 5.3
|
10.3 ± 5.0
|
0.92
|
Gestational age(days)
|
272.4 ± 12.6
|
271.3 ± 8.0
|
1.00
|
273.9 ± 11.0
|
272.54 ± 7.0
|
1.00
|
273.4 ± 10.5
|
271.9 ± 8.5
|
0.43
|
273.08 ± 7.8
|
271.1 ± 7.6
|
1.00
|
Severe ICP
|
2.1(4)
|
2.0(4)
|
1.00
|
1.1(9)
|
1.7(2)
|
0.91
|
2.3(6)
|
1.4(1)
|
0.95
|
2.4(3)
|
1.2(1)
|
0.92
|
Gestational Hypertension /Preeclampsia
|
2.7(5)
|
0.0(0)
|
1.00
|
1.7(14)
|
2.3(4)
|
0.73
|
4.7(12)
|
2.7(2)
|
0.68
|
8.8(11)
|
9.6(8)
|
0.84
|
chorionitis
|
1.6(3)
|
6.7(1)
|
0.69
|
1.7(14)
|
1.7(2)
|
1.00
|
0.4(1)
|
1.1(1)
|
0.93
|
0.8(1)
|
2.4(2)
|
0.74
|
PPROM
|
22.3(42)
|
46.7(7)
|
0.03
|
18.9(158)
|
18.3(22)
|
0.93
|
20.3(52)
|
20.3(15)
|
0.99
|
14.4(18)
|
20.5(17)
|
0.25
|
Primary cesarean section
|
22.9(43)
|
6.7(1)
|
0.25
|
24.8(207)
|
23.3(28)
|
0.85
|
28.9(74)
|
33.8(25)
|
0.42
|
38.4(48)
|
31.3(26)
|
0.29
|
Total cesarean section
|
39.3(74)
|
26.7(4)
|
0.49
|
49.0(410)
|
63.3(76)
|
0.003
|
52.3(134)
|
63.5(47)
|
0.09
|
68.8(86)
|
68.7(57)
|
0.99
|
Postpartum Hemorrhage
|
3.2(6)
|
20(3)
|
0.02
|
2.3(19)
|
1.7(2)
|
0.93
|
0.8(2)
|
4.1(3)
|
0.14
|
0.8(1)
|
2.4(2)
|
0.72
|
perinatal outcomes
|
Neonatal jaundice
|
16.5(31)
|
20.0(3)
|
1.00
|
14.8(124)
|
19.2(23)
|
0.22
|
12.5(32)
|
36.5(27)
|
< 0.01
|
20.0(25)
|
25.3(21)
|
0.37
|
LGA
|
6.9(12)
|
0.0(0)
|
0.60
|
14.7(119)
|
19.2(23)
|
0.20
|
14.3(36)
|
28.8(21)
|
0.004
|
24.6(30)
|
28.4(23)
|
0.55
|
SGA
|
7.4(14)
|
0.0(0)
|
0.57
|
3.6(26)
|
0.0(0)
|
0.098
|
1.9(5)
|
1.4(1)
|
1.00
|
2.4(3)
|
2.4(2)
|
1.00
|
Infant of low-birth weight
|
5.3(10)
|
0.0(0)
|
0.76
|
3.0(25)
|
1.67(2)
|
0.517
|
3.5(9)
|
2.7(2)
|
1.00
|
2.4(3)
|
2.4(2)
|
0.64
|
Macrosomia
|
0.6(1)
|
0.0(0)
|
1.00
|
4.2(34)
|
5.1(6)
|
0.66
|
3.2(8)
|
3.6(8)
|
0.007
|
4.1(5)
|
16.0(13)
|
0.003
|
Premature
|
4.8(9)
|
6.7(1)
|
1.00
|
4.2(35)
|
3.3(4)
|
0.85
|
4.3(11)
|
6.8(5)
|
0.39
|
4.8(6)
|
6(5)
|
0.70
|
Neonatal asphyxia
|
3.2(6)
|
0.0(0)
|
1.00
|
2.2(18)
|
3.0(6)
|
0.06
|
2.3(6)
|
2.7(2)
|
1.00
|
3.2(4)
|
3.6(3)
|
1.00
|
Apgar 1min < 7
|
1.1(2)
|
0.0(0)
|
1.00
|
0.6(5)
|
5.0(6)
|
< 0.001
|
1.6(4)
|
2.6(2)
|
0.90
|
0.8(1)
|
3.6(3)
|
0.35
|
NICU admission
|
1.6(3)
|
6.7(1)
|
0.69
|
4.1(34)
|
5.0(6)
|
0.63
|
5.5(14)
|
12.2(9)
|
0.046
|
7.2(9)
|
7.2(6)
|
0.99
|
Categorical variables were presented as %(n); continuous variables were presented as mean ±SD if normally distributed and as median ( interquartile rang) if not normally distributed .
Gravidity(≥2times), Parity(≥1times), Interval between the last childbirth(≥6years), Macrosomia (birth weight > 4kg), Infant of low-birth weight (birth weight <2.5kg), Premature delivery (gestational age < 37 weeks), LGA (defined as birth weight >P 90 according to standardized birth charts adjusted for the sex of the baby and parity), SGA (defined as birth weight <P10 according to standardized birth charts adjusted for the sex of the baby and parity).
Differences were considered significant at p<0.005
a1 vs a2, c1 vs c2, e1 vs e2, g1 vs g2(p<0.05), b1 vs b2, d1 vs d2, f1 vs f2, h1 vs h2(p>0.05)
Further analysis of subgroup outcomes provided additional insights. Subgroup B had higher rates of PROM (46.7% vs 22.3, p = 0.03) and postpartum hemorrhage (20% vs 3.2%, p = 0.02) compared to subgroup A. Subgroups C and D showed differences in 1-minute scores (5% vs 0.6%, p < 0.001) and previous obstetric history, such as gravidity, parity, interval between the last childbirth, and cesarean section. Subgroup F had higher rates of LGA (28.8% vs 14.3%, p = 0.004), macrosomia (3.6% vs 3.2%, p = 0.007), neonatal jaundice (36.5% vs12.5%, p < 0.001), and NICU admission (12.2% vs 5.5%, p = 0.046) compared to subgroup E. Subgroup H had higher macrosomia (16% vs4.1%, p = 0.003) and history of hypothyroidism compared to subgroup G (refer to Table 3).