Factors predicting recurrence of gestational diabetes in a high-risk multi-ethnic population.
Aust N Z J Obstet Gynaecol
; 59(6): 831-836, 2019 12.
Article
em En
| MEDLINE
| ID: mdl-30937896
ABSTRACT
BACKGROUND:
Women with gestational diabetes mellitus (GDM) have an increased risk of adverse pregnancy outcomes. This study examined predictors for GDM recurrence at their next pregnancy in a multi-ethnic population. Clinical outcomes of women with GDM at the index as well as the subsequent pregnancies were also compared. MATERIALS ANDMETHODS:
A retrospective review of women with GDM (between 2008 and 2016) who had a subsequent pregnancy at a tertiary institution was conducted. The clinical characteristics of both pregnancies were documented.RESULTS:
Among 3587 singleton pregnancies complicated by GDM, 501 fell pregnant again and 367 (73.1%) developed GDM in their subsequent pregnancies. Subsequent pregnancies had higher birthweight (3426 ± 563 vs 3290 ± 506 g, P < 0.001) but the rate of pre-eclampsia was lower (1.0% vs 4.2%, P = 0.003). Univariate analysis showed that older age, prior history of GDM, pre-pregnant body mass index (BMI), two-hour glucose level on glucose tolerance test (GTT), insulin requirement at the index pregnancy, and inter-pregnancy weight gain were associated with recurrent GDM. Using stepwise logistic regression analysis, pre-pregnant BMI, glucose levels on GTT at index pregnancy and inter-pregnancy weight gain were independent predictors for recurrent GDM. The odds ratios for recurrent GDM among those who gained more than 8 kg were 20.5 (5.0-84.5), compared with those who lost over 5 kg between the two pregnancies. GDM recurrence rate was independent of ethnic backgrounds.CONCLUSION:
Women with GDM have high risk of GDM recurrence at their next pregnancy. Inter-pregnancy weight gain is a strong predictor of recurrent GDM, and strategies to help women lose weight post-partum may be invaluable.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Etnicidade
/
Diabetes Gestacional
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
/
Pregnancy
País/Região como assunto:
Oceania
Idioma:
En
Revista:
Aust N Z J Obstet Gynaecol
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
Austrália