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Recurrence of gestational diabetes: who is at risk?

Abstract

OBJECTIVE

The object was to determine the recurrence rate of gestational diabetes mellitus and to find various risk factors that might increase this rate.

STUDY DESIGN

Seventy-eight patients with gestational diabetes mellitus in their index pregnancies were evaluated in subsequent pregnancies. Medical records for the index and subsequent pregnancies were abstracted for age, parity, body mass index, birth weight, gestational age of gestational diabetes mellitus diagnosis, insulin requirement, weight gain, and interval between pregnancies. These variables were then compared between patients with and without gestational diabetes mellitus in their subsequent pregnancies.

RESULTS

Fifty-four of 78 patients (69%) had gestational diabetes mellitus in a subsequent pregnancy. The recurrence of gestational diabetes mellitus was more common when the following variables were present in the index pregnancy: parity > or = 1 (P < .004; odds ratio 3.0, 95% confidence interval 1.4-4.8), body mass index > or = 30 kg/m2 (P < .04; odds ratio 3.6, 95% confidence interval 1.1-25.9), gestational diabetes mellitus diagnosis at < or = 24 gestational weeks (P < .0003; odds ratio 20.4, 95% confidence interval 2.5-444), and insulin requirement (P < .0002; odds ratio 2.3, 95% confidence interval 1.3-3.4). A weight gain of > or = 15 pounds (P < .003; odds ratio 2.9, 95% confidence interval 1.0-5.3) and an interval between pregnancies < or = 24 months (P < .03; odds ratio 1.6, 95% confidence interval 1.1-2.2) were also associated with a recurrence of gestational diabetes mellitus. A multiple logistic regression analysis revealed that an interval of < or = 24 months and a weight gain of > or = 15 pounds between pregnancies were most strongly correlated with a recurrence of gestational diabetes mellitus.

CONCLUSIONS

Gestational diabetes mellitus is more likely to recur in parous, obese women who had an early gestational diabetes mellitus diagnosis and required insulin in the index pregnancy. In addition, a shorter interval (< or = 24 months) and a larger weight gain (> or = 15 pounds) between pregnancies appear to be the most significant risk factors for a recurrence of gestational diabetes mellitus.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Department of Obstetrics and Gynecology, University of California at Irvine, Orange, USA.

    , ,

    Source

    MeSH

    Age Factors
    Birth Weight
    Body Mass Index
    Diabetes, Gestational
    Female
    Gestational Age
    Humans
    Insulin
    Logistic Models
    Parity
    Pregnancy
    Recurrence
    Risk Factors
    Weight Gain

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    9790394

    Citation

    Major, C A., et al. "Recurrence of Gestational Diabetes: Who Is at Risk?" American Journal of Obstetrics and Gynecology, vol. 179, no. 4, 1998, pp. 1038-42.
    Major CA, deVeciana M, Weeks J, et al. Recurrence of gestational diabetes: who is at risk? Am J Obstet Gynecol. 1998;179(4):1038-42.
    Major, C. A., deVeciana, M., Weeks, J., & Morgan, M. A. (1998). Recurrence of gestational diabetes: who is at risk? American Journal of Obstetrics and Gynecology, 179(4), pp. 1038-42.
    Major CA, et al. Recurrence of Gestational Diabetes: Who Is at Risk. Am J Obstet Gynecol. 1998;179(4):1038-42. PubMed PMID: 9790394.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Recurrence of gestational diabetes: who is at risk? AU - Major,C A, AU - deVeciana,M, AU - Weeks,J, AU - Morgan,M A, PY - 1998/10/28/pubmed PY - 1998/10/28/medline PY - 1998/10/28/entrez SP - 1038 EP - 42 JF - American journal of obstetrics and gynecology JO - Am. J. Obstet. Gynecol. VL - 179 IS - 4 N2 - OBJECTIVE: The object was to determine the recurrence rate of gestational diabetes mellitus and to find various risk factors that might increase this rate. STUDY DESIGN: Seventy-eight patients with gestational diabetes mellitus in their index pregnancies were evaluated in subsequent pregnancies. Medical records for the index and subsequent pregnancies were abstracted for age, parity, body mass index, birth weight, gestational age of gestational diabetes mellitus diagnosis, insulin requirement, weight gain, and interval between pregnancies. These variables were then compared between patients with and without gestational diabetes mellitus in their subsequent pregnancies. RESULTS: Fifty-four of 78 patients (69%) had gestational diabetes mellitus in a subsequent pregnancy. The recurrence of gestational diabetes mellitus was more common when the following variables were present in the index pregnancy: parity > or = 1 (P < .004; odds ratio 3.0, 95% confidence interval 1.4-4.8), body mass index > or = 30 kg/m2 (P < .04; odds ratio 3.6, 95% confidence interval 1.1-25.9), gestational diabetes mellitus diagnosis at < or = 24 gestational weeks (P < .0003; odds ratio 20.4, 95% confidence interval 2.5-444), and insulin requirement (P < .0002; odds ratio 2.3, 95% confidence interval 1.3-3.4). A weight gain of > or = 15 pounds (P < .003; odds ratio 2.9, 95% confidence interval 1.0-5.3) and an interval between pregnancies < or = 24 months (P < .03; odds ratio 1.6, 95% confidence interval 1.1-2.2) were also associated with a recurrence of gestational diabetes mellitus. A multiple logistic regression analysis revealed that an interval of < or = 24 months and a weight gain of > or = 15 pounds between pregnancies were most strongly correlated with a recurrence of gestational diabetes mellitus. CONCLUSIONS: Gestational diabetes mellitus is more likely to recur in parous, obese women who had an early gestational diabetes mellitus diagnosis and required insulin in the index pregnancy. In addition, a shorter interval (< or = 24 months) and a larger weight gain (> or = 15 pounds) between pregnancies appear to be the most significant risk factors for a recurrence of gestational diabetes mellitus. SN - 0002-9378 UR - https://www.unboundmedicine.com/medline/citation/9790394/Recurrence_of_gestational_diabetes:_who_is_at_risk L2 - https://linkinghub.elsevier.com/retrieve/pii/S000293789870211X DB - PRIME DP - Unbound Medicine ER -