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Endocrine Abstracts (2021) 79 015 | DOI: 10.1530/endoabs.79.015

1Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, 3000 Leuven, Belgium; 2Biomedical Sciences, KU Leuven, Belgium; 3Department of Endocrinology, Imelda Hospital, 2820 Bonheiden, Belgium; 4Department of Endocrinology-Diabetology-Metabolism, Antwerp University Hospital, 2650 Edegem, Belgium; 5Department of Endocrinology, OLV Hospital Aalst, 9300 Aalst, Belgium; 6Department of Endocrinology, General Hospital Groeninge, 8510 Kortrijk, Belgium; 7Department of Endocrinology, GZA Hospital Sint-Vincentius, 2018 Antwerp, Belgium; 8Department of Endocrinology, GZA Hospital Sint-Augustinus, 2610 Wilrijk, Belgium; 9Department of Endocrinology, General Hospital Klina, 2930 Brasschaat, Belgium; 10Department of Endocrinology, University Hospitals Leuven, 3000 Leuven, Belgium; 11Department of Laboratory Medicine, University Hospitals Leuven, 3000 Leuven, Belgium; 12Department of Electrical Engineering, Processing Speech and Images, KU Leuven, 3000 Leuven, Belgium; 13Centre of Biostatics and Statistical Bioinformatics, KU Leuven, 3000 Leuven, Belgium; 14Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium; 15Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care (CRIC), University of Antwerp, 2610 Wilrijk, Belgium


Aims: To identify factors associated with early postpartum weight retention (PPWR) in women with recent gestational diabetes mellitus (GDM).

Methods: Multicentric prospective study in women with a recent history of GDM based on the IADPSG criteria at the oral glucose tolerance test (OGTT) 6-16 weeks postpartum. Data obtained from electronic medical records, self-administered questionnaires, clinical examination and blood sample collection were used for the analysis. Early PPWR was defined as the difference between the maternal weight measured at the postpartum OGTT and the prepregnancy weight (kg).

Results: Of all 535 participants at the postpartum OGTT, 30.6% (164) had an impaired OGTT [28.8% (154) glucose intolerance and 1.9% (10) diabetes]. Of all women with an impaired OGTT, 32.9% (54) had impaired fasting glucose (IFG), 52.4% (86) impaired glucose tolerance (IGT) and 14.6% (24) had IFG and IGT combined. Weight retention (PPWR > 0 kg) was observed in 53.8% (288) of all women, with 14.4% (77) retaining more than 5 kg. Women with PPWR > 0 kg (288) had less often a higher education degree [65.4% (187) vs. 78.0% (191), P = 0.015], had more often a history of smoking [33.5% (90) vs. 23.2% (54), P = 0.013], lower prepregnancy BMI [24.9 kg/m2(22.0-28.3) vs. 26.5 kg/m2(23.3-30.7), P < 0.001] and more often excessive gestational weight gain (GWG) [28.7% (75) vs. 6.6% (15), P < 0.001] compared to women without PPWR (247). Babies born to mothers with PPWR > 0 kg were more often small-for-gestational-age (SGA) [8.0% (23) vs. 2.8% (7) with an odds ratio (OR) adjusted for education, smoking history, prepregnancy BMI and GWG of 3.58 (95% CI 1.34-9.57), P = 0.011]. At the postpartum visit, women with PPWR > 0 kg had a higher BMI [26.2 kg/m2(23.1-29.9) vs. 25.3 kg/m2(22.3-29.3), P = 0.033], higher fasting triglycerides [88.0 mg/dl (60.0-124.0) vs. 70.0 mg/dl (55.0-99.0), P < 0.001] and higher fasting plasma glucose (FPG) [90.0 mg/dl (84.5-96.5) vs. 88.0 mg/dl (83.0-95.0), P = 0.016] compared to women without PPWR. They gave less often breastfeeding [49.8% (143) vs. 65.0% (160), P < 0.001] and had a lower dietary quality index [77.5 (6.2-83.6) vs. 78.8 (72.1-84.2), P = 0.041].

Conclusions: Different factors such as education level, smoking status, excessive GWG and SGA are associated with PPWR at the postpartum OGTT in women with a recent history of GDM. Women with PPWR have a worse metabolic profile in early postpartum and give less often breastfeeding compared to women without PPWR.

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