Objective: Short interpregnancy intervals are associated with a number of adverse perinatal outcomes and their prevention is a public health priority. Among women with a history of gestational diabetes (GDM), short interpregnancy intervals further decrease the timeframe for postpartum glucose optimization and testing for type 2 diabetes prior to the next conception. The objective of this study was to evaluate whether women with GDM have higher rates of short interpregnancy intervals.
Methods: Data from the 2011-2017 National Survey on Family Growth were analyzed. Study sample included 28,443 women aged 18-44y. Primary outcome was short interpregnancy intervals, defined as pregnancies conceived within 18 months after a previous birth. The rates of short interpregnancy intervals were compared between women with and without GDM using bivariate analysis. Multivariable logistic regression was done to assess independent association between GDM and short interpregnancy intervals.
Results: Out of 28,443 women included in the analysis, 2,827 (9.9%) had diagnosis of GDM. Short interpregnancy intervals rates were higher in women with GDM compared to controls (56.4% vs. 43.6%, p<0.001). In bivariate analysis, GDM significantly increased the odds of short interpregnancy intervals compared to controls (OR=1.43, 95% CI 1.22-1.66). After controlling for maternal age, body mass index, race/ethnicity, marital status, education, insurance, family income, contraception use and history of sexually transmitted infections, GDM remained to be independently associated with a higher rate of short interpregnancy intervals (aOR=1.49, 95% CI 1.26-1.76).
Conclusion: Women with GDM have higher rates of short interpregnancy intervals. Reducing short interpregnancy intervals in this population will not only reduce perinatal risks of short interpregnancy intervals but will also allow time for adequate preconception counseling for screening and management of type 2 diabetes prior to future pregnancy.
R. Anguzu: None. L.E. Egede: None. A.R. Shour: None. A. Palatnik: None.