Utility of antenatal clinical factors for prediction of postpartum outcomes in women with gestational diabetes mellitus (GDM)

Abstract

Antenatal clinical factors were modestly predictive of return for testing and abnormal glucose tolerance post-pregnancy in women with GDM. Risk score calculations were ineffective in predicting outcomes: risk scores developed in other populations require validation. Ongoing glucose screening is indicated for all women with GDM.

The relationship between total cholesterol and postpartum impaired glucose tolerance in women with gestational diabetes mellitus

“…In addition, only 30.1% of the included women returned to the hospital for OGTT at 6-12 weeks postpartum in the study. The adherence rate was far lower than that in previous studies, in which the rates were 45-70.9% [19,[36][37][38]. One of the possible reasons was that residences of participants were too far from the hospital to return for OGTT easily.…”

“…* There are women who met more than one of the exclusion criteria c level less than 50 mg dl − 1 at the time of GDM diagnosis and age older than 35 years were the best predictors of the development of type 2 diabetes after GDM [12]. Another study demonstrated that women whose FBG was ≥5.4 mmol L − 1 , 2-h BG was ≥9.3 mmol L − 1 at the time of GDM diagnosis, or who had a history of polycystic ovary syndrome were at higher risk of developing glucose intolerance [19].…”

“…Previous studies investigated the incidence of disorders of glucose metabolism in the early postpartum period after recent GDM. Ingram et al found that 11.1% (13/ 117) and 8.5% (10/117) of GDM women who underwent OGTT at 6-12 weeks postpartum suffered IFG and IGT, respectively, and none of the women had overt diabetes in a study conducted in Australia [19]. Carmody et al reported that 5.7% (67/1149), 9.0% (104/1149) and 3.8% (43/1149) of women who had a history of GDM developed IFG, IGT and type 2 diabetes, respectively, from January 2008 to December 2012 in a study conducted in Ireland [32].…”

Diabetes risk in women with gestational diabetes mellitus and a history of polycystic ovary syndrome: a retrospective cohort study

“…Although the effect estimate was higher than in the present study, the CI was wider, indicating a less precise estimate. Similarly, a 2016 chart review-based retrospective cohort study including 165 women in Australia (12 PCOS cases) estimated an incident rate ratio of 1.69 (95% CI 0.48, 5.92) [13]. This estimate was closer to ours, but their findings were inconclusive.…”

“…Two small studies to date suggest that PCOS confers an increased postpartum risk of Type 2 diabetes beyond the risk conferred by GDM alone [12,13]. A larger-scale study with a longer follow-up interval is needed.…”