Risk factors differ for first time, recurrent gestational diabetes
Gestational diabetes recurred for nearly half of women with a prior history of the condition, with elevated fasting glucose level, high maternal birth weight and maternal obesity conferring added risk, according to study data.
“With the implementation of the diagnostic criteria for gestational diabetes by the International Association of Diabetes and Pregnancy Study Group Consensus Panel, the prevalence of gestational diabetes has increased significantly,” Li Zhang, MD, of the Beijing Maternal and Child Health Care Hospital and the division of endocrinology and metabolism at Beijing Obstetrics and Gynecology Hospital, and colleagues wrote. “Yet, little is known about the prevalence and associated risk factors for recurrent gestational diabetes since the wide acceptance of the new criteria in diagnosing gestational diabetes.”
Zhang and colleagues assessed prevalence and risk factors for recurrent gestational diabetes among 10,151 women with at least two singleton pregnancies who delivered between 2016 and 2019 in Beijing.
Of the 8.6% of the cohort who had a history of gestational diabetes, 48.34% had recurrent gestational diabetes and 7.89% developed preexisting type 1 or type 2 diabetes. Among women with no prior history of gestational diabetes, 16% had gestational diabetes and 0.5% had preexisting diabetes with a subsequent pregnancy (P ˂ .0001 for both comparisons).
Risk factors for first-time gestational diabetes included older maternal age (OR = 1.06; 95% CI, 1.04-1.09), higher prepregnancy BMI (OR = 1.09; 95% CI, 1.07-1.11), longer interval between the two pregnancies (OR = 1.05; 95% CI, 1.03-1.07), greater early pregnancy weight gain (OR = 1.08; 95% CI, 1.05-1.12), family history of type 2 diabetes (OR = 1.52; 95% CI, 1.3-1.78), maternal low birth weight (OR = 1.47; 95% CI, 1.1-1.96), and elevated early pregnancy fasting blood glucose (OR = 4.58; 95% CI, 3.88-5.41) and triglycerides (OR = 1.71; 95% CI, 1.54-1.9).
Risk factors for recurrent gestational diabetes included higher prepregnancy BMI (OR = 1.07; 95% CI, 1.02-1.12), higher FBG (OR = 2.26; 95% CI, 1.58-3.25), and maternal birth weight either low (OR = 1.32; 95% CI, 0.72-2.4) or high (OR = 1.84; 95% CI, 1.02-3.31).
Risk for recurrent gestation diabetes also rose with multiple risk factors, with an OR of 4.65 (95% CI, 2.68-8.08) for those with prior gestational diabetes plus two risk factors.
“Recognizing these additional factors antepartum can help to identify a high-risk population in order to prevent recurrent gestational diabetes and may also provide an opportunity to explore pathogenesis of recurrent gestational diabetes,” the researchers wrote.
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