Endocrine Abstracts

Background: Gestational diabetes mellitus (GDM) impacts more than 18 million births annually with lifelong risks of type 2 diabetes and cardiovascular disease. Recurrence risk is well established, little is known about the outcomes of subsequent normal glucose tolerance pregnancies in women with prior GDM.

Objective: To examine the pregnancy outcomes of women with normal glucose tolerance in pregnancies following the diagnosis of GDM in a previous pregnancy.

Methods: We examined the outcomes of subsequent pregnancies in women diagnosed with GDM 2016-2020. Data on maternal demographics, laboratory values, maternal, and neonatal outcomes were collected from electronic medical records. Only women who had a; ⁷⁵g OGTT in the subsequent pregnancy were included and classified as recurrent GDM (rGDM) or a normal glucose tolerance pregnancy (NGTP).

Results: In total, 386 number of women had GDM between 2016-2020. Of these, 166 (43%) went on to have another pregnancy. Only 16 (9.6%) had NGTP, the remainder had GDM. There was no difference in age or body mass index between those with rGDM vs NGTP (34.1 vs 34.5 years and 29.5 vs 23.6 kg/m2 respectively), high rates of obesity were observed in both groups (40.9% vs 37.5%). Women with NGTP had high rates of caesarean delivery (43.8%), foetal macrosomia (18.8%), neonatal care admission (12.5%), respiratory distress (6.3%) and depression (18.8%). No significant differences were determined between those with NGTP and rGDM.

Conclusion: Women with NGTP encounter high rates of serious adverse complications despite the absence of metabolic derangement and their pregnancies should be risk stratified accordingly.