The Parity Factor: Understanding Its Role in Gestational Diabetes, finds study

Recent investigation assessed the relationship between parity and gestational diabetes mellitus (GDM) occurrence while considering additional influencing factors among a large cohort of Chinese women. The prevalence of GDM has significantly increased, particularly in China, driven by rising rates of obesity, advanced maternal age, and changing reproductive policies. GDM, associated with numerous adverse outcomes for both mothers and infants, necessitates a clearer understanding of its risk factors.

Understanding Parity's Role

Parity, defined as the number of times a woman has given birth, has been inconsistently associated with GDM in existing literature. Some studies suggest that higher parity may reduce the risk due to physiological changes that enhance insulin sensitivity, while others indicate that it may increase risk. This study aimed to elucidate the independent effect of parity on GDM risk while adjusting for confounders including maternal age and pre-pregnancy body mass index (BMI), both recognized as significant GDM predictors.

Data Analysis and Findings

Data from 198,237 participants, collected via the Shenzhen Maternal and Child Health Information Management System, revealed significant variations in GDM prevalence with parity. The prevalence was higher among multiparous women compared to nulliparous, particularly in the 30-45 age group. Logistic regression models indicated that multiparae had a lower risk of GDM than primiparae, confirmed after controlling for age, education, ethnicity, and pre-pregnancy BMI. Notably, the interaction between maternal age and parity indicated that the protective effect of multiparity was more pronounced in women aged 20-29 years compared to older groups.

Possible Mechanisms Behind GDM Risk

Further analysis suggested that several psychosocial and physiological mechanisms might contribute to the observed decreased GDM risk in multiparous women. Multiparae generally possess greater prenatal awareness and adherence to health guidelines gained from previous pregnancies, potentially leading to better dietary and health management, reducing GDM risk. Moreover, higher physical activity levels due to socioeconomic conditions and social support among multiparous women may further mitigate stress and enhance pregnancy outcomes. Despite the robustness of the study, limitations included the reliance on clinical records for GDM diagnosis which may introduce bias and the single-center nature of the study affecting generalizability. The findings indicate the essentiality of addressing parity in GDM risk assessments, especially highlighting the need for targeted counseling in nulliparous women of advanced maternal age, aiming to effectively reduce GDM incidence through informed reproductive planning. Further research is warranted to explore the underlying mechanisms influencing parity and GDM risk.

Key Points

- -Prevalence and Context-: The study highlights a significant increase in the prevalence of gestational diabetes mellitus (GDM) in China, attributed to rising obesity rates, advanced maternal age, and shifting reproductive policies, underscoring the necessity for a deeper understanding of GDM risk factors.

- -Parity's Inconsistent Association-: Parity's relationship with GDM has been inconsistent in existing literature, with some studies suggesting higher parity might lower GDM risk due to enhanced insulin sensitivity, while others indicate it could increase risk. This investigation aimed to clarify the independent effects of parity on GDM, adjusting for confounding variables like maternal age and pre-pregnancy BMI.

- -Cohort Data and Findings-: An analysis of 198,237 participants from the Shenzhen Maternal and Child Health Information Management System demonstrated that multiparous women had a higher prevalence of GDM compared to nulliparous women, particularly within the 30-45 age bracket. Logistic regression showed that multiparae had a lower risk of GDM than primiparae once accounting for confounders.

- -Impact of Maternal Age on Parity-: The interaction between maternal age and parity revealed that the protective effect of multiparity against GDM risk was more significant in younger women (ages 20-29) than in older demographics, suggesting that age modulates the influence of parity on GDM risk.

- -Psychosocial and Physiological Mechanisms-: Analysis indicated potential psychosocial and physiological mechanisms contributing to reduced GDM risk in multiparous women, such as enhanced prenatal awareness and adherence to health guidelines from previous pregnancies, along with increased physical activity and social support.

- -Study Limitations and Implications-: Acknowledged limitations include reliance on clinical records for GDM diagnosis, which could introduce bias, and the study's single-center approach affecting generalizability. Findings emphasize the importance of incorporating parity in GDM risk assessments, advocating for targeted counseling for nulliparous women of advanced maternal age to mitigate GDM incidence and support informed reproductive planning. Further research is needed to investigate the mechanisms governing the relationship between parity and GDM risk.

Reference –

Yuqin Dai et al. (2025). Impact Of Parity On Gestational Diabetes Mellitus In Chinese Women: A Retrospective Cohort Study. *BMC Pregnancy And Childbirth*, 25. https://doi.org/10.1186/s12884-025-07620-1.