AIMS: To determine occurrence and recurrence rates of gestational diabetes among women having at least two consecutive pregnancies. Risk factors for recurrence of gestational diabetes and rates of second/third pregnancy pre-existing diabetes mellitus were also assessed. METHODS: Population-based study using longitudinally linked hospital discharge and birth records (2001-2009) in NSW, Australia. Participants included women without a pre-existing diagnosis of Type 1 or Type 2 diabetes at time of first pregnancy and with at least a first and second birth. Factors associated with recurrence of gestational diabetes were examined using multivariate log-binomial models to adjust for correlation within mothers and estimate relative risks and 95% confidence intervals. RESULTS: First occurrence of gestational diabetes was 3.7% (5315/142 843) in the first pregnancy and 2.7% (3689/137 528) in the second pregnancy. The recurrence rate of gestational diabetes in a second consecutive pregnancy was 41.2%. Risk of pre-existing diabetes in a pregnancy subsequent to one with first occurrence of gestational diabetes was 2.2% and 2.0% in the second or third pregnancy, respectively. Among women with a diagnosis of gestational diabetes in the first pregnancy, independent predictors of gestational diabetes recurrence were maternal age ≥ 35 years, ethnicity (Middle East/North Africa and Asia), pregnancy hypertension, large for gestational age infant and preterm birth in the first pregnancy, longer inter-pregnancy birth interval and pregnancy hypertension and multiple pregnancy in the second pregnancy. CONCLUSIONS: Gestational diabetes in a previous pregnancy is a strong indicator of future risk and a useful clinical marker for identifying women at elevated risk in a subsequent pregnancy.
AIMS: To determine occurrence and recurrence rates of gestational diabetes among women having at least two consecutive pregnancies. Risk factors for recurrence of gestational diabetes and rates of second/third pregnancy pre-existing diabetes mellitus were also assessed. METHODS: Population-based study using longitudinally linked hospital discharge and birth records (2001-2009) in NSW, Australia. Participants included women without a pre-existing diagnosis of Type 1 or Type 2 diabetes at time of first pregnancy and with at least a first and second birth. Factors associated with recurrence of gestational diabetes were examined using multivariate log-binomial models to adjust for correlation within mothers and estimate relative risks and 95% confidence intervals. RESULTS: First occurrence of gestational diabetes was 3.7% (5315/142 843) in the first pregnancy and 2.7% (3689/137 528) in the second pregnancy. The recurrence rate of gestational diabetes in a second consecutive pregnancy was 41.2%. Risk of pre-existing diabetes in a pregnancy subsequent to one with first occurrence of gestational diabetes was 2.2% and 2.0% in the second or third pregnancy, respectively. Among women with a diagnosis of gestational diabetes in the first pregnancy, independent predictors of gestational diabetes recurrence were maternal age ≥ 35 years, ethnicity (Middle East/North Africa and Asia), pregnancy hypertension, large for gestational age infant and preterm birth in the first pregnancy, longer inter-pregnancy birth interval and pregnancy hypertension and multiple pregnancy in the second pregnancy. CONCLUSIONS:Gestational diabetes in a previous pregnancy is a strong indicator of future risk and a useful clinical marker for identifying women at elevated risk in a subsequent pregnancy.
Authors: Katherine J Sapra; Alexander C McLain; José M Maisog; Rajeshwari Sundaram; Germaine M Buck Louis Journal: Ann Epidemiol Date: 2015-05-07 Impact factor: 3.797
Authors: Mahesh V Katreddy; Joseph M Pappachan; Sarah E Taylor; Alan M Nevill; Radha Indusekhar; Ananth U Nayak Journal: World J Diabetes Date: 2013-06-15