Clinical characteristics, gestational weight gain and pregnancy outcomes in women with a history of gestational diabetes mellitus

Lirui Zhang,Guanghui Li,Li Zhang,Zhihong Tian,Xin Liang,Cheng Liu,Wei Zheng

doi:10.1186/s13098-021-00694-9

Abstract

BackgroundPregnant women with a history of gestational diabetes mellitus (GDM) are at high risk of GDM. It is unclear whether this population has pregnancy characteristics different from the general population. Whether these features affect the perinatal outcome has not yet been elucidated.MethodsA retrospective study was conducted, including baseline characteristics, laboratory data, gestational weight gain (GWG), and pregnancy outcomes of 441 pregnant women with prior GDM. Besides, 1637 women without a history of GDM treated in the same period were randomly selected as the control group. The above indicators of the two groups were compared. Multivariable logistic regression analysis was performed to investigate how GWG was associated with perinatal outcomes for previous GDM women.ResultsAmong women with GDM history, triglycerides (TG) and fasting plasma glucose (FPG) in the 1st trimester were higher than those without GDM history. GWG was lower in women with prior GDM relative to the control group at various pregnancy stages. However, women with GDM history had a higher risk of developing GDM (OR 3.25, 95% CI 2.26–4.68) and pregnancy-induced hypertension (OR 1.50, 95% CI 1.05–2.45). In women with previous GDM, excessive GWG before OGTT exhibited a positive correlation with pregnancy-induced hypertension (OR 1.47, 95% CI 1.05–3.32), while inadequate GWG was not a protective factor for GDM and pregnancy-induced hypertension.ConclusionWomen with prior GDM have glucose and lipid metabolism disorders in the 1st trimester. Limited reduction of GWG before oral glucose tolerance test (OGTT) was insufficient to offset the adverse effects of glucose and lipid metabolism disorders in women with previous GDM. Relevant interventions may be required at early stage or even before pregnancy.

Highlights

Pregnant women with a history of gestational diabetes mellitus (GDM) are at high risk of GDM
gestational weight gain (GWG) at various pregnancy stages were lower in women with previous GDM than those without GDM history, we still found a higher risk of GDM and pregnancy-induced hypertension in women with prior GDM
Our findings suggested that GWG before 16 weeks and GWG before oral glucose tolerance test (OGTT) were significantly lower in women with GDM history than those without GDM history

Summary

Introduction

Pregnant women with a history of gestational diabetes mellitus (GDM) are at high risk of GDM It is unclear whether this population has pregnancy characteristics different from the general population. Most articles have focused on postpartum metabolic characteristics of women with GDM history, but less attention has been given to the differences between women with previous GDM and the general pregnant women during a subsequent pregnancy. In this regard, our study attempted to elucidate different clinical characteristics, glucose metabolism, lipid metabolism, gestational weight gain (GWG) at various stages of pregnancy, and pregnancy outcomes of women with GDM history and those without GDM history. We investigated GWG effect before oral glucose tolerance test (OGTT) on pregnancy outcomes of women with prior GDM, aiming to produce relevant information to guide proper management methods during pregnancy and reduce related adverse maternal and infant outcomes

Methods

Results

Discussion

Conclusion