Abstract
Objective
This study aimed to evaluate the effect of interpregnancy interval (IPI) on the gestational
diabetes mellitus (GDM) recurrence rate in the subsequent pregnancies following an
initial pregnancy complicated by GDM.
Study Design
A multicenter, retrospective cohort study was conducted. The study included women
diagnosed with GDM during their index pregnancy who subsequently delivered between
26 and 42 weeks of gestation from 2005 to 2021. The study population was categorized
into eight groups according to their IPIs: up to 3, 3–5, 6–11, 12–17, 18–23, 24–35,
36–47, and over 48 months. We examined the recurrence rate of GDM in the different
groups while comparing it to the 18–23-month group that was defined as the reference
group. Statistical analyses included univariate analyses and multiple logistic regression.
Results
Out of 3,532 women who were included in the study, 1,776 (50.3%) experienced GDM recurrence
in subsequent pregnancy. The recurrence rate was 44.6% for women IPI <6 months, 42.6%
for women IPI of 6–11 months, 48.0% for women IPI of 12–17 months, 49.7% for women
IPI of 18–23 months, 58.0% for women IPI of 24–47 months, and 62.6% for women IPI
above 48 months. Multivariable logistic regression revealed that IPIs of 24–47 months
and over 48 months were significantly associated with higher recurrence rates as compared
with the 18–23-month reference group (adjusted odds ratio [aOR], 95% confidence interval
[CI]: 1.66 [1.04–2.64] and 3.15 [1.07–9.29], respectively). This analysis also revealed
other independent risk factors for GDM recurrence, including medication-controlled
GDM in the index pregnancy, obesity, maternal age, parity, and gravidity.
Conclusion
Longer IPIs (over 24 months) are associated with an increased risk of GDM recurrence
in subsequent pregnancies. These findings suggest that clinicians should consider
IPI while managing postpartum care and planning future pregnancies for women with
a history of GDM.
Key Points
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Longer IPIs (over 24 months) are associated with an increased risk of GDM recurrence.
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Clinicians should consider IPI while managing postpartum care for women with a history
of GDM.
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GDM A1, obesity, maternal age, parity, and gravidity were found as risk factors for
GDM recurrence.
Keywords
gestational diabetes - interpregnancy interval - recurrence - postpartum management
- obesity - maternal age
