Association of body mass index and recurrence of gestational diabetes mellitus

Abstract

To assess whether body mass index (BMI) is associated with recurrence of gestational diabetes mellitus (GDM) among pregnant persons with a history of GDM in a prior pregnancy. This was a retrospective cohort study of births in California between 2000-2012 to pregnant persons who had a history of GDM in a prior pregnancy. Births at gestational ages 23-42 weeks were included if they were also singleton and non-anomalous, and we excluded those who developed pre-existing diabetes mellitus between pregnancies or with missing data for BMI. We assessed race/ethnicity, age, educational attainment and insurance type as potential confounders. We performed statistical analyses using chi-squared and multivariable logistic regression with a p-value of 0.05. There were 15,112 births that met our inclusion criteria. Pregnant persons were significantly different for all sociodemographic characteristics by recurrence of GDM. This highest proportion of GDM recurrence occurred among the highest BMI group (63%). We found that the adjusted odds of GDM recurrence was higher among all BMI groups higher than the referent, while the adjusted odds of GDM recurrence was lower for the lowest BMI group. We found that among pregnant persons with a history of GDM, there was a higher adjusted odds of GDM recurrence with higher-than-normal BMI and lower adjusted odds with underweight BMI. Future studies should assess prevention strategies among those with a history of GDM planning another pregnancy to reduce the recurrence of GDM.