Subsequent pregnancy after gestational diabetes mellitus: frequency and risk factors for recurrence in Korean women.
OBJECTIVE
The purpose of this study was to determine the frequency of recurrent gestational diabetes mellitus (GDM) and to find risk factors that can predict the recurrence of GDM in Korean women with previous GDM.


METHODS
We evaluated women who had GDM in an index pregnancy (1993-2001) and a subsequent pregnancy by 2003. An oral glucose tolerance test (OGTT) was performed during the index pregnancy and 2 months postpartum. The recurrence rate of GDM was assessed among 111 women who had a subsequent pregnancy. Multivariate logistic regression analysis was used to identify independent predictors of recurrent GDM.


RESULTS
The frequency of recurrent GDM in subsequent pregnancies was 45.0% (95% CI 35.6-54.4%). Women with impaired fasting glucose and/or impaired glucose tolerance 2 months postpartum were at increased risk for recurrent GDM (relative risk 2.31, 95% CI 1.24-4.30). Higher BMI before the subsequent pregnancy (P = 0.024), higher fasting glucose concentration (P = 0.007) 2 months postpartum, and lower 1-h insulin concentration (P = 0.004) of the diagnostic OGTT in the index pregnancy were independent risk factors for recurrence of GDM in subsequent pregnancies.


CONCLUSIONS
GDM recurred in nearly half of subsequent pregnancies in Korean women. Fasting glucose 2 months postpartum might be a clinically valuable predictor of recurrent GDM risk.
Kwak
Soo Heon
SH
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Kim
Hae Sung
HS
Choi
Sung Hee
SH
Lim
Soo
S
Cho
Young Min
YM
Park
Kyong Soo
KS
Jang
Hak C
HC
Kim
Moon Young
MY
Cho
Nam H
NH
Metzger
Boyd E
BE
D015992:Body Mass Index; D016640:Diabetes, Gestational / Q000097:blood / Q000453:epidemiology*; D005260:Female; D005951:Glucose Tolerance Test; D006801:Humans; D015994:Incidence; D007723:Korea / Q000453:epidemiology; D049590:Postpartum Period / Q000502:physiology; D011247:Pregnancy; D012008:Recurrence; D012307:Risk Factors