Adverse metabolic outcomes in the early and late postpartum after gestational diabetes are broader than glucose control.

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License: CC BY 4.0
Serval ID
serval:BIB_F25B647AF42F
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Adverse metabolic outcomes in the early and late postpartum after gestational diabetes are broader than glucose control.
Journal
BMJ open diabetes research & care
Author(s)
Kosinski C., Rossel J.B., Gross J., Helbling C., Quansah D.Y., Collet T.H., Puder J.J.
ISSN
2052-4897 (Electronic)
ISSN-L
2052-4897
Publication state
Published
Issued date
11/2021
Peer-reviewed
Oui
Volume
9
Number
2
Pages
e002382
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
Gestational diabetes mellitus is associated with an increased cardiovascular risk. To better target preventive measures, we performed an in-depth characterization of cardiometabolic risk factors in a cohort of women with gestational diabetes in the early (6-8 weeks) and late (1 year) postpartum.
Prospective cohort of 622 women followed in a university gestational diabetes clinic between 2011 and 2017. 162 patients who attended the late postpartum visit were analyzed in a nested long-term cohort starting in 2015. Metabolic syndrome (MetS) was based on the International Diabetes Federation definition, and then having at least two additional criteria of the MetS (blood pressure, triglycerides, high-density lipoprotein (HDL) cholesterol, plasma glucose above or below the International Diabetes Federation cut-offs).
Compared with prepregnancy, weight retention was 4.8±6.0 kg in the early postpartum, and the prevalence of obesity, pre-diabetes, MetS-body mass index (BMI) and MetS-waist circumference (WC) were 28.8%, 28.9%, 10.3% and 23.8%, respectively. Compared with the early postpartum, weight did not change and waist circumference decreased by 2.6±0.6 cm in the late postpartum. However, the prevalence of obesity, pre-diabetes, MetS-WC and MetS-BMI increased (relative increase: 11% for obesity, 82% for pre-diabetes, 50% for MetS-WC, 100% for MetS-BMI; all p≤0.001).Predictors for obesity were the use of glucose-lowering treatment during pregnancy and the prepregnancy BMI. Predictors for pre-diabetes were the early postpartum fasting glucose value and family history of diabetes. Finally, systolic blood pressure in pregnancy and in the early postpartum, the 2-hour post oral glucose tolerance test glycemia and the HDL-cholesterol predicted the development of MetS (all p<0.05).
The prevalence of metabolic complications increased in the late postpartum, mainly due to an increase in fasting glucose and obesity, although weight did not change. We identified predictors of late postpartum obesity, pre-diabetes and MetS that could lead to high-risk identification and targeted preventions.
Keywords
Blood Glucose, Diabetes, Gestational/diagnosis, Diabetes, Gestational/epidemiology, Female, Humans, Postpartum Period, Pregnancy, Prospective Studies, Risk Factors, gestational diabetes mellitus, glucose intolerance, metabolic syndrome, obesity
Pubmed
Web of science
Open Access
Yes
Create date
15/11/2021 16:27
Last modification date
22/01/2022 7:32
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