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Risk factors associated with early postpartum glucose intolerance in women with a history of gestational diabetes mellitus: a systematic review and meta-analysis

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Abstract

Purpose

This meta-analysis was aimed at exploring the incidence and risk factors of glucose intolerance in women with gestational diabetes mellitus (GDM) at 6–12 weeks postpartum to inform the development of preventive strategies.

Method

We searched Pubmed, Embase, Web of Science, the Cochrane Library, Ovid, China Knowledge Resource Integrated Database (CNKI), Wanfang Database and China Biology Medicine Database for entries between January 1990 and September 2022. The search terms included gestational diabetes mellitus, postpartum, glucose intolerance and type 2 diabetes. The meta-analysis was conducted using Stata 14.0.

Result

We included 37 studies, with 21 and 16 having low and medium risk of bias, respectively. The incidence of glucose intolerance in women with GDM 6–12 weeks postpartum was 27% (95% CI: 0.22–0.33). The following risk factors for GDM 6–12 weeks postpartum were identified: insulin use during pregnancy (OR = 3.23; 95% CI: 2.35–4.44), family history of diabetes (OR = 2.94; 95% CI: 1.98–4.33), abnormal fasting glucose levels at 24–28 weeks of gestation (OR = 1.15; 95% CI: 1.07–1.25), high pre-pregnancy BMI (OR = 1.63; 95% CI: 1.23–2.15), abnormal triglyceride levels during 28–40 weeks of gestation (OR = 2.18; 95% CI: 1.18–4.03), abnormal HbA1c levels at 28–40 weeks of gestation (OR = 6.62; 95% CI: 4.71–9.30), history of previous GDM (OR = 2.11; 95% CI: 1.27–3.49), and high 1-h glucose levels at 24–28 weeks of gestation (OR = 1.16; 95% CI:1.06–1.28).

Conclusion

The incidence of glucose intolerance in GDM patients at 6–12 weeks postpartum was high. To prevent early postpartum glucose intolerance, healthcare providers should develop individualized interventions for GDM patients, depending on existing risk factors.

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Data availability

All data are available in the submitted paper or as electronic Supplementary Material.

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Funding

This work was supported by the National Natural Science Foundation of China (project number: 71904133) and Medjaden Academy & Research Foundation for Young Scientists (Grant No. MJA202306038).

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  1. School of Nursing, Capital Medical University, Beijing, China

    Zhe Liu, Qianghuizi Zhang, Leyang Liu & Weiwei Liu

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Study design was performed by W.L. and Z.L. Material preparation, data collection and analysis were performed by Z.L., Q.Z. and L.L. The first draft of the manuscript was written by Z.L. W.L. edited and provided feedback on the first draft of the manuscript. All authors read and approved the final manuscript.

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Liu, Z., Zhang, Q., Liu, L. et al. Risk factors associated with early postpartum glucose intolerance in women with a history of gestational diabetes mellitus: a systematic review and meta-analysis. Endocrine 82, 498–512 (2023). https://doi.org/10.1007/s12020-023-03472-x

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