Almost half of women with a history of gestational diabetes are at risk of developing it again in a subsequent pregnancy, suggests a new study reported in the journal BMC Endocrine Disorders.¹ Factors like high fasting blood glucose level, maternal overweight and obesity further enhanced this risk.

This study from China analysed the risk factors for recurrent gestational diabetes mellitus (GDM) and newly diagnosed GDM in 10,151 multipara women with singleton pregnancy with childbirth between 2016 and 2019.

Out of the 10,151 women included in the study, 875 (8.6%) had a positive history of GDM in earlier pregnancies. The prevalence of GDM was 48.34% (423/875) in women with previous diagnosis of GDM as compared to 16% (1484/9276) in women with no history of GDM. Similarly the prevalence of pre-gestational diabetes mellitus (PGDM) was higher in women with prior GDM than women without a history of GDM; 7.89% vs. 0.50%, respectively.

Higher pre-pregnancy body mass index (PPBMI), higher fasting glucose levels and maternal birth weight ≥4000 g were found to have a strong correlation with recurrence of GDM in multipara women with a past history of GDM. Whereas, risk factors for GDM in women without past history of GDM were older age, higher PPBMI, longer gap between the two pregnancies, higher early pregnancy weight gain, positive family history of type 2 diabetes, maternal low birth weight and higher early pregnancy glycemic and lipid indexes.

The presence of one risk factor in addition to a positive history of GDM increased the risk of recurrence of GDM from 44% to 58% (odds ratio 1.73). Presence of ≥2 risk factors along with history of GDM increased the risk of recurrence of GDM from 44% to 78% (OR 4.65).

Women with a past history of GDM are at greater risk of developing it again in the next pregnancy compared to women who did not have gestational diabetes. Notably, this study also highlights the differences in the risk profiles for recurrent and new-onset GDM in multipara women. While a history of GDM in itself does raise an alert in subsequent pregnancy, identification of other risk factors enables individualized risk reduction strategies in at-risk women to prevent recurrent GDM.

Reference

1. Zhang L, et al. Differing risk factors for new onset and recurrent gestational diabetes mellitus in multipara women: a cohort study. BMC Endocr Disord. 2022 Jan 5;22(1):3. doi: 10.1186/s12902-021-00920-5.