![]() To determine whether neutrophil count was an independent risk factor, logistic regression analysis was performed with GDM classified in a binary manner (presence/absence) as the dependent variable. Continuous association of neutrophil count with GDM incidence was determined by spline regression analysis. Linear correlation between neutrophil count and HOMA-IR and prepregnancy BMI and newborn weight were assessed by simple and multivariate linear regression analysis. HOMA-IR, HOMA-β, and QUICKI were log-transformed previously for t tests or ANOVA. Nonnormally distributed variables were analyzed by Kruskal-Wallis one-way ANOVA or Wilcoxon tests. Bonferroni correction was applied in multiple comparisons. ANOVA and the Student t test were used to identify the difference in the mean between groups. ![]() Descriptive statistics for the studied variables are presented as means ± SD for normally distributed variables, median (interquartile range ) for nonnormally distributed variables, and frequency (percentage) for categorical variables. ![]() To further validate the association of neutrophil count with GDM and pregnancy outcomes, a cohort including the same subjects as the case-control study was established in which patients were divided into three groups by tertiles of neutrophil count: lowest group (6.80 × 10 9/L). This work suggested that the first-trimester neutrophil count is closely associated with the development of GDM and adverse pregnancy outcomes. Spline regression showed that there was a significant linear association between GDM incidence and the continuous neutrophil count when it was >5.0 × 10 9/L. Additionally, neutrophil count was an independent risk factor for the development of GDM, regardless of the history of GDM. Neutrophil count was positively associated with prepregnancy BMI, HOMA-IR, and newborn weight. The results showed that as the neutrophil count increased, there was a stepwise increase in GDM incidence as well as in glucose and glycosylated hemoglobin levels, HOMA for insulin resistance (HOMA-IR), macrosomia incidence, and newborn weight. Subjects were grouped based on tertiles of neutrophil count during their first-trimester pregnancy. First-trimester neutrophil count outperformed white blood cell count and the neutrophil-to-lymphocyte ratio in the predictability for GDM. To investigate the ability of different inflammatory blood cell parameters in predicting the development of GDM and pregnancy outcomes, 258 women with GDM and 1,154 women without were included in this retrospective study. Chronic low-grade inflammation plays a central role in the pathophysiology of gestational diabetes mellitus (GDM).
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