Abstract 59: Prenatal predictive factors and prevalence of early postpartum maternal dysglycemia in patients with gestational diabetes

Abstract

Background: Women with gestational diabetes mellitus (GDM) have increased risk of postpartum diabetes which may be further exacerbated by fat accretion during pregnancy and post-partum deterioration in lifestyle behaviours.Aims and objectives: To determine prenatal predictive factors and prevalence of maternal dysglycemia at 6-12weeks postpartum in patients with GDM.Results: In this prospective cohort study, of 118 subjects recruited initially, only 83 (81.3%) followed for postpartum screening. Among them 38.56%, 22.89% and 8.43% had family history of Diabetes Mellitus, Previous history of GDM and PCOD respectively. We observed that 62.7% reverted to NGT postpartum, however; 8.4%, 3.6%, 10.8% and14.5% had IFG, IGT, IFG+IGT and overt DM respectively.In univariate analysis, BMI (p=0.001), family history of DM (p=0.008), PCOD (p=0.012), impaired fasting glucose (p<0.001), HbA1c at diagnosis (p<0.001) and fetal macrosomia (p=0.019) were the risk factors for postpartum diabetes. However on Multivariate analyses, only HbA1c at diagnosis, Family history of DM and BMI showed statistically significant association with postpartum diabetes.Conclusion: GDM patients have a high prevalence of postpartum glucose intolerance and diabetes. The prenatal risk factors identified could be useful for prenatal risk stratification for early detection and interventions to reduce the risk of progression and complications of diabetes mel.