| Summary: | Objective To investigate the incidence of gestational diabetes mellitus (GDM) in 2 general hospitals in Wuxi and the effect of lifestyle intervention on the occurrence of GDM and pregnancy outcomes in high-risk population. Methods From February, 2014 to January, 2015, a total of 14 141 pregnant women receiving routine antenatal care in Wuxi People's Hospital and Wuxi Maternal and Child Health Hospital were screened for high risk factors of GDM using a questionnaire. According to the results of questionnaire screening, the women were divided into normal pregnancy group (n=8 290, aged 26.36±2.13 years) and high risk for GDM group (n=4 869, aged 27.32±3.79 years). The women with high risks for GDM were randomized into lifestyle intervention group (n=3 645, aged 27.35±3.85 years) and control group (n=1 224, aged 27.29±4.12 years); in the intervention group, the women were provided with health education and guidance for diet, exercise and blood glucose control. All the women were followed up to the endpoints (an established diagnosis of GDM and the end of pregnancy), and the incidence of GDM, changes in body mass index (BMI) and pregnancy outcomes were compared among the 3 groups. Results The overall incidence of GDM was 11.43% in this cohort. A total of 13 159 women were followed up to the predetermined endpoints. The incidence of GDM was 9.01% in normal pregnancy group, 13.42% in high-risk intervention group and 23.28% in high-risk control group, showing a significant difference among the 3 groups (P < 0.01). Compared with those in high-risk control group, the women in high-risk intervention group had a significantly lower BMI before delivery (P < 0.01) and significantly lower rates of preterm birth, threatened premature labor, fetal growth retardation, hydramnios, intrauterine distress, postpartum bleeding and pregnancy-related anemia (P < 0.01). Conclusion Early lifestyle intervention can significantly reduce BMI and the incidence of GDM in pregnant women at high risks of GDM to improve the pregnancy outcomes.
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