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Risk Factors for New Onset and Recurrent Gestational Diabetes Mellitus
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In this prospective cohort study of multiparous women with singleton pregnancies examined the risk factors for recurrent and newly diagnosed gestational diabetes mellitus (GDM). GDM was significantly less common in women without a history of GDM. Risk factors for newly diagnosed GDM included older maternal age, higher BMI, prolonged interval between two pregnancies, higher early pregnancy weight gain, family history of type 2 diabetes, maternal low birth weight, and high early-pregnancy glycemic and lipid indexes. GDM recurred in nearly 50% of pregnancies.
- Risk factors for new onset GDM and recurrent GDM differ. Recognizing risk factors for GDM in both groups may facilitate early identification of high risk populations for GDM.
abstract
This abstract is available on the publisher's site.
Access this abstract nowOBJECTIVES
To assess whether recurrent gestational diabetes mellitus (GDM) and newly diagnosed GDM share similar risk factors.
METHODS
The study recruited a cohort of 10,151 multipara women with singleton pregnancy who delivered between 2016 and 2019 in Beijing, China. The prevalence of recurrent GDM and associated risk factors were analyzed between women with and without prior GDM history.
RESULTS
Eight hundred and seventy-five (8.6%) multipara women had a diagnosis of GDM during previous pregnancies. The prevalence of GDM and pre-gestational diabetes mellitus were 48.34% (423/875) and 7.89% (69/875) if the women were diagnosed with GDM during previous pregnancies, as compared to 16.00% (1484/9276) and 0.50% (46/9276) if the women were never diagnosed with GDM before. In women without a history of GDM, a variety of factors including older maternal age, higher pre-pregnancy body mass index (PPBMI), prolonged interval between the two pregnancies, higher early pregnancy weight gain, family history of type 2 diabetes mellitus (T2DM), maternal low birth weight, and higher early pregnancy glycemic and lipid indexes were generally associated with an increased risk of GDM at subsequent pregnancy. In women with a history of GDM, higher PPBMI, higher fasting glucose level and maternal birthweight ≥4000 g were independent risk factors for recurrent GDM.
CONCLUSIONS
GDM reoccurred in nearly half of women with a history of GDM. Risk factors for recurrent GDM and newly diagnosed GDM were different. Identifying additional factors for GDM recurrence can help guide clinical management for future pregnancies to prevent GDM recurrence.
Additional Info
Differing risk factors for new onset and recurrent gestational diabetes mellitus in multipara women: a cohort study
BMC Endocr Disord 2022 Jan 05;22(1)3, L Zhang, W Zheng, W Huang, L Zhang, X Liang, G LiFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
Gestational diabetes mellitus (GDM) is a serious condition affecting ~10% of pregnancies and has acute and long-term adverse maternal, fetal, and neonatal effects. The main objective of the study by Zhang et al was to determine whether the risk factors (RF) for recurrent GDM differed from RFs for new-onset GDM in a cohort of multiparous pregnant individuals. This prospective cohort included more than ten thousand singleton pregnancies between 2016 and 2019 in China, 876 of whom had GDM in a prior pregnancy.
The authors found that individuals who have GDM in one pregnancy have nearly a 50% risk of developing GDM again and that the RFs associated with recurrent GDM differ from the RFs associated with new-onset GDM. Body mass index and higher fasting glucose in early pregnancy were significant predictors for both recurrent and new-onset GDM. Recurrent GDM was also associated with maternal birth weight >4000 grams. In contrast increasing maternal age, greater inter pregnancy time intervals, early pregnancy weight gain, higher triglyceride levels, low maternal birth weight, and family history of diabetes were all predictors for new onset GDM in this cohort. This study had two major limitations; 1) the study population was ethnically homogenous and 2) GDM history in a prior pregnancy was based on participant self-report and so, subject to recall bias. While the findings from this study must be confirmed in other populations, they do highlight that individuals with prior GDM represent a special group at extremely high risk for future GDM and that in this group, only a few risk factors may identify those most likely to develop GDM again.