Inês Gante1, Ana Carina Ferreira2, Gonçalo Pestana3, Daniela Pires4,5, Njila Amaral6, Jorge Dores7, Maria do Céu Almeida8, José Luis Sandoval9. 1. Department of Obstetrics, Maternidade Bissaya Barreto - Centro Hospitalar e Universitário de Coimbra, Rua Augusta, 3000-061, Coimbra, Portugal. inesrcgante@gmail.com. 2. Department of Nephrology, Hospital Curry Cabral - Centro Hospitalar Lisboa Central, Rua Beneficência 8, 1069-166, Lisbon, Portugal. 3. Department of Cardiology, Centro Hospitalar de São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal. 4. Department of Infectious Diseases, Centro Hospitalar de Lisboa Norte and Faculdade de Medicina de Lisboa, Av. Egas Moniz, 1649-035, Lisbon, Portugal. 5. Infection Control Program, Geneva University Hospitals, Rue Gabrielle Perret-Gentil, 1205, Geneva, Switzerland. 6. Department of Obstetrics and Gynecology, Hospital Beatriz Angelo, Avenida Carlos Teixeira 3, 2674-514, Loures, Portugal. 7. Department of Endocrinology, Centro Hospitalar do Porto, Largo Prof. Abel Salazar, 4099-001, Porto, Portugal. 8. Department of Obstetrics, Maternidade Bissaya Barreto - Centro Hospitalar e Universitário de Coimbra, Rua Augusta, 3000-061, Coimbra, Portugal. 9. Unit of Population Epidemiology, Department of Community Medicine, Primary Care, and Emergency Medicine, Geneva University Hospitals, Rue Gabrielle Perret-Gentil, 1205, Geneva, Switzerland. jose.sandoval@cantab.net.
Abstract
AIMS: Gestational diabetes mellitus (GDM) occurs in 5-15% of pregnancies, and lower maternal educational attainment has been associated with higher risk of GDM. We aimed to determine if maternal education level is associated with persistent post-partum glucose metabolism disorders in women with GDM. METHODS: Retrospective cohort study of women with GDM followed in 25 Portuguese health institutions between 2008 and 2012. Educational attainment was categorised into four levels. Prevalence of post-partum glucose metabolism disorders (type 2 diabetes mellitus, increased fasting plasma glucose or impaired glucose tolerance) was compared and adjusted odds ratios calculated controlling for confounders using logistic regression. RESULTS: We included 4490 women diagnosed with GDM. Educational level ranged as follows: 6.8% (n = 307) were at level 1 (≤ 6th grade), 34.6% (n = 1554) at level 2 (6-9th grade), 30.4% (n = 1364) at level 3 (10-12th grade) and 28.2% (n = 1265) at level 4 (≥ university degree). At 6 weeks post-partum re-evaluation, 10.9% (n = 491) had persistent glucose metabolism disorders. Educational levels 1 and 2 had a higher probability of persistent post-partum glucose metabolism disorders when compared to level 4 (OR = 2.37 [1.69;3.32], p < 0.001 and OR = 1.39 [1.09;1.76], p = 0.008, for level 1 and 2, respectively), an association that persisted in multivariable logistic regression adjusting for confounders (level 1 OR = 2.25 [1.53;3.33], p < 0.001; level 2 OR = 1.43 [1.09;1.89], p = 0.01). CONCLUSIONS: Persistent post-partum glucose metabolism disorders are frequent in women with GDM and associated with lower maternal educational level. Interventions aimed at this risk group may contribute towards a decrease in prevalence of post-partum glucose metabolism disorders.
AIMS: Gestational diabetes mellitus (GDM) occurs in 5-15% of pregnancies, and lower maternal educational attainment has been associated with higher risk of GDM. We aimed to determine if maternal education level is associated with persistent post-partum glucose metabolism disorders in women with GDM. METHODS: Retrospective cohort study of women with GDM followed in 25 Portuguese health institutions between 2008 and 2012. Educational attainment was categorised into four levels. Prevalence of post-partum glucose metabolism disorders (type 2 diabetes mellitus, increased fasting plasma glucose or impaired glucose tolerance) was compared and adjusted odds ratios calculated controlling for confounders using logistic regression. RESULTS: We included 4490 women diagnosed with GDM. Educational level ranged as follows: 6.8% (n = 307) were at level 1 (≤ 6th grade), 34.6% (n = 1554) at level 2 (6-9th grade), 30.4% (n = 1364) at level 3 (10-12th grade) and 28.2% (n = 1265) at level 4 (≥ university degree). At 6 weeks post-partum re-evaluation, 10.9% (n = 491) had persistent glucose metabolism disorders. Educational levels 1 and 2 had a higher probability of persistent post-partum glucose metabolism disorders when compared to level 4 (OR = 2.37 [1.69;3.32], p < 0.001 and OR = 1.39 [1.09;1.76], p = 0.008, for level 1 and 2, respectively), an association that persisted in multivariable logistic regression adjusting for confounders (level 1 OR = 2.25 [1.53;3.33], p < 0.001; level 2 OR = 1.43 [1.09;1.89], p = 0.01). CONCLUSIONS: Persistent post-partum glucose metabolism disorders are frequent in women with GDM and associated with lower maternal educational level. Interventions aimed at this risk group may contribute towards a decrease in prevalence of post-partum glucose metabolism disorders.
Entities:
Keywords:
Diabetes; Education; Gestational; Post-partum; Women