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DOI: 10.1055/s-0029-1241733
Prediction of Diabetes Recurrence in Women with Class A1 (Diet-Treated) Gestational Diabetes
Publication History
Publication Date:
05 October 2009 (online)
ABSTRACT
We sought to evaluate the likelihood of recurrent diabetes in women with a prior history of diet-treated (class A1) gestational diabetes mellitus (GDM). In a retrospective cohort analysis, nulliparous women diagnosed based upon National Diabetes Data Group criteria with diet-treated GDM who had recurrent diabetes in a subsequent pregnancy were compared with those who did not have recurrent diabetes. The probability of recurrent diabetes was calculated using maternal age at first pregnancy, interpregnancy interval, and body mass index (BMI) during the subsequent pregnancy. Three hundred forty-four nulliparous women with diet-treated GDM had a subsequent delivery in our database. One hundred thirty-seven (40%) had recurrent diabetes. Women with a history of GDM were more likely to have recurrent diabetes if they were heavier (193 versus 173 lbs; p < 0.001; BMI 35.7 versus 32.2; p < 0.001) and waited longer between pregnancies (2.9 versus 2.4 years, p = 0.02). Age, interpregnancy interval, and BMI can be used to predict diabetes recurrence in pregnant women with a history of GDM.
KEYWORDS
Risk factors for recurrent diabetes in pregnancy
REFERENCES
- 1 American Diabetes Association . Gestational diabetes mellitus. Diabetes Care. 1986; 9 430-431
- 2 American Diabetes Association . Gestational diabetes mellitus. Diabetes Care. 2003; 26(Suppl 1) S103-S105
- 3 O'Sullivan J B, Mahan C M. Criteria for oral glucose tolerance test in pregnancy. Diabetes. 1964; 13 278-285
- 4 Carpenter M W, Coustan D R. Criteria for screening tests for gestational diabetes. Am J Obstet Gynecol. 1982; 144 768-773
-
5 O'Sullivan J B.
Subsequent morbidity among GDM women . In: Sutherland HW, Stowers JM Carbohydrate Metabolism in Pregnancy and the Newborn. New York; Churchill Livingstone 1984: 174-180 - 6 Center for Disease Control and Prevention .National agenda for public health action: a national public health initiative on diabetes and women's health. Available at: http://www.cdc.gov/diabetes/pubs/action/facts.htm Last accessed February 14, 2005
- 7 Di Cianni G, Miccoli R, Volpe L, Lencioni C, Del Prato S. Intermediate metabolism in normal pregnancy and in gestational diabetes. Diabetes Metab Res Rev. 2003; 19 259-270
- 8 Major C A, deVeciana M, Weeks J, Morgan M A. Recurrence of gestational diabetes: who is at risk?. Am J Obstet Gynecol. 1998; 179 1038-1042
- 9 Philipson E H, Super D M. Gestational diabetes mellitus: does it recur in subsequent pregnancy?. Am J Obstet Gynecol. 1989; 160 1324-1329 discussion 1329-1331
- 10 Gaudier F L, Hauth J C, Poist M, Corbett D, Cliver S P. Recurrence of gestational diabetes mellitus. Obstet Gynecol. 1992; 80 755-758
- 11 National Diabetes Data Group .Classification and diagnosis of diabetes mellitus in pregnancy. ACOG Technical Bulletin No. 92. Washington, DC; ACOG 1982
- 12 Interactive Nomogram Creation Tool. Available at: http://www.ece.rochester.edu/∼jones/NomoDevel/nomopage.htm Last accessed March 2, 2005
- 13 Moses R G. The recurrence rate of gestational diabetes in subsequent pregnancies. Diabetes Care. 1996; 19 1348-1350
- 14 MacNeill S, Dodds L, Hamilton D C, Armson B A, VandenHof M. Rates and risk factors for recurrence of gestational diabetes. Diabetes Care. 2001; 24 659-662
- 15 Spong C Y, Guillermo L, Kuboshige J, Cabalum T. Recurrence of gestational diabetes mellitus: identification of risk factors. Am J Perinatol. 1998; 15 29-33
- 16 Foster-Powell K A, Cheung N W. Recurrence of gestational diabetes. Aust N Z J Obstet Gynaecol. 1998; 38 384-387
- 17 Farrell M. Improving the care of women with gestational diabetes. MCN Am J Matern Child Nurs. 2003; 28 301-305
- 18 American College of Obstetricians and Gynecologists .Gestational diabetes. Practice Bulletin No 30. Washington, DC; ACOG 2001
- 19 Jolly M C, Sebire N J, Harris J P, Regan L, Robinson S. Risk factors for macrosomia and its clinical consequences: a study of 350,311 pregnancies. Eur J Obstet Gynecol Reprod Biol. 2003; 111 9-14
- 20 Casey B M, Lucas M J, Mcintire D D, Leveno K J. Pregnancy outcomes in women with gestational diabetes compared with the general obstetric population. Obstet Gynecol. 1997; 90 869-873
- 21 Yang X, Hsu-Hage B, Dong L et al.. Intensive diabetes management may improve pregnancy: outcomes in Chinese gravidas with impaired glucose tolerance. Diabetes Care. 2003; 26(1 suppl 1) 254-255
Heather J HolmesM.D.
Assistant Professor, Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Texas Tech University Health Sciences Center Amarillo
1400 South Coulter, Amarillo, Texas 79106
Email: heather.j.holmes@ttuhsc.edu