Icon Legend

This session is not in your schedule.

This session is in your schedule. Click again to remove it.

Presentation Icons

Additional registration fee required

Faculty have requested this content not be shared on social media

CME Credit Offered

Poster Icons

Foundation Awardee

No Social Media

Back

Q&A

Diabetes

Poster Session 3

(914) Once GDM, always GDM? Pregnancy with GDM preceding non-GDM pregnancy- A retrospective cohort study

Wednesday, February 14, 2024

8:30 AM – 10:00 AM

Location: Prince George's Exhibit Hall CDE, Lower Atrium Level

Primary & Presenting Author(s)

Yael Shalev Rosenthal, MD, MPH

Rabin medical center
Petach-Tikva, HaMerkaz, Israel

Coauthor(s)

EH

Eran Hadar, Prof.

Rabin Medical Center
Petach-Tikva, HaMerkaz, Israel
AR

Adam Rosenthal, BSc, MSc

Shaare Zedek Medical Center, Hebrew University of Jerusalem
Jerusalem, Yerushalayim, Israel
Shai Ram, MD

Lis Hospital for Women, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
Ra'anana, Tel Aviv, Israel
HS

Hila Shalev, MD

Meir Medical Center
Kfar sava, HaMerkaz, Israel
SG

Shir Gruber, BSc, MD

Helen Schneider Hospital for Women, Rabin Medical Center
Tel Aviv, Israel, Israel
Anat Pardo, MD (she/her/hers)

OB/Gyn Specialist
Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva
Ramat Hasharon, Israel
AS

Anat Shmueli, MD

Rabin medical center
Petach-Tikva, HaMerkaz, Israel

Objective: To investigate whether women previously diagnosed with gestational diabetes mellitus (GDM) but not in a subsequent pregnancy present similar diabetes-related complications, despite the lack of diagnosis.

Study Design: A retrospective cohort design was employed, including women with at least two consecutive births at Rabin Medical Center between July 2012 and December 2022. Participants were categorized into three groups: GDM in both pregnancies (group 1), GDM in the first but not in the subsequent pregnancy (group 2), and no GDM in both pregnancies (group 3). Groups were compared for various diabetes-related complications.

Results:
The study population comprised 19,703 women. Group 2 showed higher rates of macrosomia (OR 1.4, 95% CI 1.01-1.92, p=0.03), large-for-gestational-age (LGA) (OR 1.6, 95% CI 1.2-2.0, p< 0.01) and preeclampsia (OR 2.35, 95% CI 1.32-4.15, p< 0.01) when compared to group 3. Rates of LGA, macrosomia and preeclampsia were similar between group 1 and 2. Both Group 1 and Group 2 exhibited significantly elevated composite maternal-neonatal outcomes compared to Group 3 (OR 1.91, 95% CI 1.58-2.3, p< 0.01 and OR 1.48, 95% CI 1.23-1.77, p< 0.01 , respectively).
In a multivariate logistic regression, the adjusted OR (accounting for age, BMI and parity) for composite maternal-neonatal outcomes was 1.75 (95% CI 1.36-2.25, p< 0.01) and 1.30 (95% CI 1.01-1.67, p=0.03) in groups 1 and 2 respectively, compared to group 3. Elective cesarean delivery rate was higher in groups 1 (22%) and 2 (13%) compared to group 3 (8.7%). However, the rate was also significantly higher in group 1 versus 2. Preterm birth rates were higher in group 1 (OR 1.7, 1.2-2.3, p< 0.01) but not 2, when compared to group 3.

Conclusion: Women with a history of GDM in a previous pregnancy but not in subsequent pregnancy are at increased risk of diabetes-related complications, including preeclampsia, macrosomia, and LGA. The findings suggest that these women may have underlying insulin resistance, as well as other, still occuring, risk factors; and their lack of diagnosis does not withhold adverse outcome.