Postpartum Metabolic Outcomes and Related Factors in Women with Gestational Diabetes Mellitus History

ABSTRACT

Objective: This study aimed to investigate early and late postpartum glycemic abnormalities and related factors in women with a history of gestational diabetes mellitus (GDM). Material and Methods: This study included 152 women aged 18-40 years who were diagnosed with GDM either by one- or two-step oral glucose tolerance test (OGTT). Sociodemographic characteristics, body mass index (BMI), biochemical parameters, and OGTT results of the participants were recorded from files. In addition, BMI, fasting plasma glucose, lipid parameters, and glycosylated hemoglobin (HbA1c) levels were measured, and OGTT was performed between 4 and 12 weeks after postpartum and at the first year. Results: The mean age of the participants was 31.86±6.096 years, and their mean BMI was 26.23±3.67 kg/m2. In the early postpartum period (4-6 weeks) after 75 g OGTT, 70.4% of patients had normal glucose tolerance (NGT), 25% had prediabetes (preDM), and 4.6% had diabetes mellitus (DM). In the late postpartum period, 48.0% of patients had NGT, 45.4% had preDM, and 6.6% had DM. BMI and HbA1c levels were significantly higher in patients with both preDM and DM than women with NGT in both early and late periods (p<0.05). In addition, BMI before and 1 year after pregnancy and HbA1c level between 4 and 6 weeks after delivery were independent risk factors for the development of dysglycemia (OR: 1.004, p<0.001; OR: 2.848, p<0.001; and OR: 4.437, p=0.016, respectively). Conclusion: Women with GDM have a high risk of developing preDM and type 2 DM in the first year after delivery.