Effects of obesity and a history of gestational diabetes on the risk of postpartum diabetes and hyperglycemia in Chinese women: Obesity, GDM and diabetes risk

Abstract

ObjectiveTo evaluate the independent or combined effects of gestational diabetes (GDM) and pre-pregnancy and postpartum BMI on the odds of postpartum diabetes and hyperglycemia. MethodsThe study samples included 1263 women with prior GDM and 705 women without GDM. Postpartum 1–7 years diabetes was diagnosed by the standard oral glucose tolerance test. ResultsThe multivariable-adjusted odds ratios among women with prior GDM, compared with those without it, were 7.52 for diabetes and 2.27 for hyperglycemia. The multivariable-adjusted odds ratios at different postpartum BMI levels (<24, 24–27.9, and ≥ 28 kg/m2) were 1.00, 2.80, and 8.08 for diabetes (Ptrend < 0.001), and 1.00, 2.10, and 4.42 for hyperglycemia (Ptrend < 0.001), respectively. Women with high body fat (≥31.9%) or abdominal obesity (≥85 cm) had a 2.7–6.9-fold higher odds ratio for diabetes or hyperglycemia. Women with both obesity and prior GDM had the highest risk of diabetes or hyperglycemia compared with non-obese women without GDM. Non-obese women with prior GDM had the same risk of diabetes and hyperglycemia as non-GDM women with obesity. When using Cox regression models, the results were very close to those using logistic regression models. ConclusionsMaternal prior GDM and pre-pregnancy or postpartum obesity contribute equally to postpartum diabetes and hyperglycemia risk.