Association between Socio-structural Factors and History of Gestational Diabetes: A Population-based Cohort Study in Hoveyzeh County

Introduction: Gestational diabetes mellitus (GDM) is associated with several consequences during pregnancy and later life. Few studies have focused on social factors related to gestational diabetes using combined indicators. Materials and Methods: The data of the Hoveyzeh cohort study were used in this study. The studied population was women aged 35-70 from Hoveyzeh County, who were enrolled in the study between May 2015 and August 2017. Socio-economic status was investigated based on education level, occupation, wealth index, and Townsend's deprivation index. SPSS software was used for data analysis. To this end, normality, chi-square, and means comparison tests were used. Also, household asset status was determined using principal component analysis (PCA), and logistic regression was used to control confounding factors. Results: A total of 5477 participants had experienced one or more pregnancies. The prevalence of gestational diabetes among the participants was 4% (221/5477). Also, GDM had a prevalence of 4.9% and 2.7% in urban and rural women, respectively (p<0.001). The logistic regression test results showed that literacy level, urbanization, and the wealth index were significantly correlated with the prevalence of gestational diabetes. Conclusion: The overall prevalence of gestational diabetes was relatively low among the participants. The higher prevalence of gestational diabetes in urban, more educated, and wealthier women can be due to differences in nutritional status, less physical activity, and more screening in these populations. Prospective studies are suggested to better understand the impact of social factors on the occurrence of gestational diabetes.