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First pregnancy risk factors and future gestational diabetes mellitus

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Gestational diabetes mellitus (GDM) affect about 17% of all pregnancies and is associated with significant short- and long-term health consequences for the mother and her offspring. Early diagnosis and prompt interventions may reduce these adverse outcomes. We aimed to identify first pregnancy characteristics as risk factors for GDM in subsequent pregnancy.

Materials and methods

A population-based nested case–control study was conducted in a large tertiary hospital. The study population included all women with two singleton consecutive pregnancies and deliveries, without GDM in the first pregnancy. Characteristics and complications of the first pregnancy were compared among cases and controls. A multivariable logistic regression model was used to study the association between pregnancy complications (in the first pregnancy) and GDM in the subsequent pregnancy, while adjusting for confounding variables.

Results

A total of 38,750 women were included in the study, of them 1.9% (n = 728) had GDM in their second pregnancy. Mothers with GDM in their second pregnancy were more likely to have the following first pregnancy complications: hypertensive disorders, perinatal mortality, maternal obesity and fetal macrosomia. Results remained significant after adjustment for maternal age and inter-pregnancy interval. Having either one of the complications increased the risk for GDM by 2.33 (adjusted OR = 2.33; 95% CI 1.93–2.82) while a combination of two complications increased GDM risk by 5.38 (adjusted OR = 5.38; 95% CI 2.85–10.17).

Conclusions

First pregnancy without GDM complicated by hypertensive disorders, perinatal mortality, maternal obesity and fetal macrosomia was associated with an increased risk for GDM in the subsequent pregnancy. Women with these complications may benefit from early detection of GDM in their subsequent pregnancy.

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Abbreviations

GDM:

Gestational diabetes mellitus

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Funding

This research did not receive any specific grants from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel

    Israel Yoles & Eyal Sheiner

  2. Clalit Health Services, The Central District, 30 Hertzl St., Rishon Le Tzion, Israel

    Israel Yoles

  3. Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel

    Tamar Wainstock

Authors
  1. Israel Yoles
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  2. Eyal Sheiner
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IY: project development, data analysis, manuscript writing. ES: project development, data analysis, manuscript editing. TW: project development, data analysis, statistical analysis, manuscript editing.

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Correspondence to Israel Yoles.

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Yoles, I., Sheiner, E. & Wainstock, T. First pregnancy risk factors and future gestational diabetes mellitus. Arch Gynecol Obstet 304, 929–934 (2021). https://doi.org/10.1007/s00404-021-06024-8

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