Association Between History of Gestational Diabetes Mellitus and the Risk of Urinary Leakage in Women: A Cross-Sectional Study

Abstract

Background and Aims

Gestational diabetes mellitus (GDM) and urinary leakage (UL) are common health issues affecting women. While certain adverse effects of GDM are known risk factors for UL, the direct association between GDM and UL remains underexplored. This study aims to investigate this relationship.

Methods

Data from 13,417 women in the National Health and Nutrition Examination Survey (NHANES) (2007–2020) were analyzed. Multivariate logistic regression models were used to explore the association between GDM and UL. Stratified and subgroup analyses, adjusted for confounding factors, and mediation analysis were conducted to investigate potential mediators.

Results

GDM is associated with an increased risk of UL. According to the multivariate logistic regression model, the unadjusted analysis showed that women with a history of GDM faced a 20.0% higher risk of UL (OR = 1.20, 95% CI 1.05–1.37, p < 0.01). After adjusting for confounding factors such as age, body mass index (BMI), and white blood cell (WBC) counts, the association remained robust, with an OR of 1.32 (95% CI 1.16–1.53, p < 0.001). This association was especially pronounced among women who smoked, were aged below 30 or above 35 years, had a poverty ratio less than 5, and exhibited WBC counts below 1000 cells/μL. Additionally, age, BMI, WBC, and systemic inflammation index (SII) were all positively linked to the severity of UL, with older age, higher BMI, greater WBC counts, and elevated SII levels corresponding to more severe UL in women. Mediation analysis revealed that both BMI and WBC count partially mediated the relationship between GDM and UL. Furthermore, after covariate adjustment, a nonlinear positive relationship was observed, with the inflection point for BMI occurring at 34.88.

Conclusions

Based on our results, we conclude that women diagnosed with GDM elevate the risk of UL, and BMI, WBC count appear to serve as mediators in this association.