title: Occurrence and recurrence of diabetes in pregnancy.
abstract: OBJECTIVE
  To determine occurrence and recurrence rates of gestational diabetes among women having at least two consecutive pregnancies. Risk factors for recurrence of gestational diabetes and rates of second/third pregnancy pre-existing diabetes mellitus were also assessed.
  
  
  METHODS
  Population-based study using longitudinally linked hospital discharge and birth records (2001-2009) in NSW, Australia. Participants included women without a pre-existing diagnosis of Type 1 or Type 2 diabetes at time of first pregnancy and with at least a first and second birth. Factors associated with recurrence of gestational diabetes were examined using multivariate log-binomial models to adjust for correlation within mothers and estimate relative risks and 95% confidence intervals.
  
  
  RESULTS
  First occurrence of gestational diabetes was 3.7% (5315/142 843) in the first pregnancy and 2.7% (3689/137 528) in the second pregnancy. The recurrence rate of gestational diabetes in a second consecutive pregnancy was 41.2%. Risk of pre-existing diabetes in a pregnancy subsequent to one with first occurrence of gestational diabetes was 2.2% and 2.0% in the second or third pregnancy, respectively. Among women with a diagnosis of gestational diabetes in the first pregnancy, independent predictors of gestational diabetes recurrence were maternal age ≥ 35 years, ethnicity (Middle East/North Africa and Asia), pregnancy hypertension, large for gestational age infant and preterm birth in the first pregnancy, longer inter-pregnancy birth interval and pregnancy hypertension and multiple pregnancy in the second pregnancy.
  
  
  CONCLUSIONS
  Gestational diabetes in a previous pregnancy is a strong indicator of future risk and a useful clinical marker for identifying women at elevated risk in a subsequent pregnancy.
authors: Clinical and Population Perinatal Research, Kolling Institute of Medical Research, Randwick, NSW, Australia. amina.khambalia@sydney.edu.au
authors: A Z
authors: AZ
authors: Khambalia
authors: J B
authors: JB
authors: Ford
authors: N
authors: N
authors: Nassar
authors: A W
authors: AW
authors: Shand
authors: A
authors: A
authors: McElduff
authors: C L
authors: CL
authors: Roberts
mesh_terms: D000328:Adult; D001721:Birth Intervals; D016640:Diabetes, Gestational / Q000453:epidemiology* / Q000208:ethnology; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000453:epidemiology / Q000208:ethnology; D008137:Longitudinal Studies; D008423:Maternal Age; D009517:New South Wales / Q000453:epidemiology; D011247:Pregnancy; D047928:Premature Birth / Q000453:epidemiology / Q000208:ethnology; D012008:Recurrence; D012307:Risk Factors