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Recurrence of gestational diabetes mellitus: identification of risk factors.
Am J Perinatol 1998; 15(1):29-33AJ

Abstract

The objective of this paper is to evaluate the influence of maternal and neonatal factors on the recurrence of gestational diabetes mellitus (GDM). A study was conducted on 164 predominantly Hispanic patients whose index pregnancy was complicated by GDM and whose subsequent consecutive pregnancy was managed at our institution between January 1988 and December 1992. The diagnosis of GDM was based on the criteria recommended by the National Diabetes Data Group using a 100-g oral glucose tolerance test. One-hundred and eleven (68%) of the 164 women had recurrence of GDM. Fifty-three (32%) did not demonstrate recurrence in their subsequent pregnancy. Patients with recurrence had GDM diagnosed earlier (30.3 vs 32.5 weeks, p = 0.03), frequently required insulin (25 vs. 8%, p <0.05) and had more hospital admissions (32 vs. 10% p <0.05) in their index pregnancy compared to women who did not have recurrence of GDM. Women who had recurrence had elevated mean third-trimester plasma glucose values: fasting 87.6 vs. 83 mg/dL, (p = 0.009) and 2-hr postprandial 109.7 vs. 102.2 mg/dL, (p = 0.008). Neonates of patients with recurrence were heavier (3656 vs. 3373 g, p = 0.004) and had an increased incidence of macrosomia (26 vs. 10%, p <0.05). No significant differences were observed in maternal age, prepregnancy body mass index, HbgA1C values, second-trimester blood glucose levels, method of delivery, incidence of shoulder dystocia and Apgar scores between the two groups of women. Hispanic patients with history of GDM have significant risk of recurrence in their subsequent pregnancy. The risk for recurrence in women is increased if GDM is diagnosed earlier, they require insulin, have elevated third-trimester plasma glucose level, and deliver macrosomic infants in their index pregnancy. It appears that obesity does not increase the risk of recurrence of gestational diabetes in Hispanics.

Authors+Show Affiliations

Department of Obstetrics and Gynecology, Harbor-UCLA Medical Center, Torrance, California, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

9475684

Citation

Spong, C Y., et al. "Recurrence of Gestational Diabetes Mellitus: Identification of Risk Factors." American Journal of Perinatology, vol. 15, no. 1, 1998, pp. 29-33.
Spong CY, Guillermo L, Kuboshige J, et al. Recurrence of gestational diabetes mellitus: identification of risk factors. Am J Perinatol. 1998;15(1):29-33.
Spong, C. Y., Guillermo, L., Kuboshige, J., & Cabalum, T. (1998). Recurrence of gestational diabetes mellitus: identification of risk factors. American Journal of Perinatology, 15(1), pp. 29-33.
Spong CY, et al. Recurrence of Gestational Diabetes Mellitus: Identification of Risk Factors. Am J Perinatol. 1998;15(1):29-33. PubMed PMID: 9475684.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Recurrence of gestational diabetes mellitus: identification of risk factors. AU - Spong,C Y, AU - Guillermo,L, AU - Kuboshige,J, AU - Cabalum,T, PY - 1998/2/25/pubmed PY - 1998/2/25/medline PY - 1998/2/25/entrez SP - 29 EP - 33 JF - American journal of perinatology JO - Am J Perinatol VL - 15 IS - 1 N2 - The objective of this paper is to evaluate the influence of maternal and neonatal factors on the recurrence of gestational diabetes mellitus (GDM). A study was conducted on 164 predominantly Hispanic patients whose index pregnancy was complicated by GDM and whose subsequent consecutive pregnancy was managed at our institution between January 1988 and December 1992. The diagnosis of GDM was based on the criteria recommended by the National Diabetes Data Group using a 100-g oral glucose tolerance test. One-hundred and eleven (68%) of the 164 women had recurrence of GDM. Fifty-three (32%) did not demonstrate recurrence in their subsequent pregnancy. Patients with recurrence had GDM diagnosed earlier (30.3 vs 32.5 weeks, p = 0.03), frequently required insulin (25 vs. 8%, p <0.05) and had more hospital admissions (32 vs. 10% p <0.05) in their index pregnancy compared to women who did not have recurrence of GDM. Women who had recurrence had elevated mean third-trimester plasma glucose values: fasting 87.6 vs. 83 mg/dL, (p = 0.009) and 2-hr postprandial 109.7 vs. 102.2 mg/dL, (p = 0.008). Neonates of patients with recurrence were heavier (3656 vs. 3373 g, p = 0.004) and had an increased incidence of macrosomia (26 vs. 10%, p <0.05). No significant differences were observed in maternal age, prepregnancy body mass index, HbgA1C values, second-trimester blood glucose levels, method of delivery, incidence of shoulder dystocia and Apgar scores between the two groups of women. Hispanic patients with history of GDM have significant risk of recurrence in their subsequent pregnancy. The risk for recurrence in women is increased if GDM is diagnosed earlier, they require insulin, have elevated third-trimester plasma glucose level, and deliver macrosomic infants in their index pregnancy. It appears that obesity does not increase the risk of recurrence of gestational diabetes in Hispanics. SN - 0735-1631 UR - https://www.unboundmedicine.com/medline/citation/9475684/Recurrence_of_gestational_diabetes_mellitus:_identification_of_risk_factors_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-2007-993894 DB - PRIME DP - Unbound Medicine ER -