Introduction: Women with gestational diabetes (GD) have an increased risk of developing future type 2 diabetes mellitus (T2DM). A reclassification oral glucose tolerance test (OGTT) is currently recomended in the postpartum period. However, most studies report a compliance rate below 50% and as low as 23%.
Objectives: We aimed to study predictors of missing postpartum OGTT in women with GD.
Materials and Methods: Retrospective study based on the national register of GD. Included women followed between 2012 and 2017. Excluded women with fetal losses and missing data on age, educational level, BMI, previous history of GD, abortion or arterial hypertension, family history of T2DM, treatment, delivery and obstetric/neonatal complications. Women with and without OGTT were compared. A logistic regression model was used to study factors associated with absence of OGTT: variables with different distribution between groups were included in the analysis.
Results and Conclusions: We studied a total of 14081 women, 4324 (30.7%) had missed postpartum OGTT. Women without OGTT were younger, more frequently foreigners, had higher BMI, more often had had previous GD, multiparity, twin pregnancies and preterm deliveries and they were less frequently diagnosed in the 1st trimester. Newborns from women without OGTT were more often macrossomic and had neonatal hypoglycemia. In the multivariate analysis, age [OR 0.96 (IC 95%: 0.95-0.96), P<0.001], BMI≥30 kg/m2 [1.13 (1.04-1.23), P=0.004], preterm delivery [1.35 (1.18-1.54), P<0.001], foreign nationality [1.33 (1.18-1.49), P<0.001], having a college degree [0.90 (0.83-0.97), P=0.01], multiparity [1.91 (1.73-2.12), P<0.001], twin pregnancy [1.39 (1.08-1.78), P=0.009], pharmacological treatment [0.68 (0.63-0.73), P<0.001], previous GD [1.16 (1.04-1.29), P=0.01], previous abortion [1.21 (1.12-1.32), P<0.001], diagnosis in the 1st trimester [0.86 (0.79-0.92), P<0.001] and neonatal hypoglycemia [1.21 (1.01-1.45), P=0.04] were associated with missing postpartum OGTT. Women with higher BMI, multiparity, foreigners, with twin pregnancies, previous history of GD, abortion, preterm delivery and neonatal hypoglycemia have an increased risk of missing OGTT. On the other hand, older women and those who needed pharmacological treatment, who have a college degree and who are diagnosed in the 1st trimester have lesser risk of missing OGTT.
21 May 2022 - 24 May 2022