1230-P: Clinical Risk Factors and First Gestational 75g OGTT May Predict Recurrent and New-Onset Gestational Diabetes in Multiparous Women

Women who had gestational diabetes mellitus (GDM) in their first pregnancy are again prone to GDM in a second pregnancy. Even women with no previous history of GDM may be at risk of GDM in a future pregnancy. Identifying women who are more likely to have recurrent or new onset GDM is important for effective planning of future pregnancies.

Multiparous women (n=759), tested for GDM in two consecutive pregnancies, were retrospectively enrolled. GDM was diagnosed by 75g OGTT (IADPSG criteria). OGTT was performed at 24-28 weeks or earlier in case of a former GDM diagnosis. To compare clinical features and OGTT glucose curves, women were divided into four groups: NGT women at both pregnancies (n=493); women with first occurrence of GDM at their second pregnancy (n=74); women with non-recurrent GDM at second pregnancy (n=92); women with recurrent GDM at second pregnancy (n=100).

Intergroup comparisons revealed clinical predictors of GDM at the first pregnancy (family history of type 2 diabetes, PCOS, early menarche, advanced maternal age, pregravid obesity) and at the second pregnancy (interpregnancy BMI gain), and predictors of recurrent GDM (pregravid obesity, PCOS). Among these women, a positive correlation was observed between the OGTT glucose curves of consecutive pregnancies. Adjusted logistic regression showed that higher level of 1h-postload glucose (ROC optimal cut-point: 130 mg/dL) at the first pregnancy would enhance the likelihood of a new occurrence of GDM in a second pregnancy (OR 2.50, 95%CI 1.51-4.13), whereas higher levels of 2h-postload glucose (ROC optimal cut-point: 153 mg/dL) at the first diagnostic OGTT would enhance the likelihood of GDM recurrence (OR 2.21, 95%CI 1.06-4.63).

Clinical risk factors, and their dynamic changes throughout female reproductive life span, as well as postload glucose at first gestational OGTT, can help predict GDM in multiparous women and tailor preventive interventions, including interpregnancy weight loss.