FACTORS PREDICTIVE OF RECURRENT GESTATIONAL DIABETES DIAGNOSED BEFORE24 WEEKS GESTATION

The purpose of this study was to determine which patient and pregnancy characteristics in the first pregnancy complicated by gestational dia betes mellitus (GDM) were associated with the diagnosis of GDM before 24 weeks' gestation in a subsequent pregnancy-early recurrent GDM. The case notes of 180 women who previously had GDM diagnosed and who had glucose tolerance tests performed before 24 weeks' gestation in their next ongoing pregnancy were reviewed. Factors examined included severi ty of GDM, insulin requirement, racial origin, macrosomia, obesity age , family history of diabetes, preeclampsia, and parity. Multivariate a nalysis showed that women with early recurrent GDM were more likely, i n their first pregnancy with GDM, to have needed insulin (odds ratio [ OR] 11.26; 95% confidence interval [CI] 2.02 to 62.65), to be more oft en of non-Northern European origin (OR, 5.53; 95% CI, 2.46 to 12.44), to have had a macrosomic infant (OR, 4.01; 95% CI, 1.40 to 11.49) or s evere GDM (OR, 3.52; 95% CI, 1.60 to 7.76), and were more often 30 yea rs or more of age (OR, 2.27; 95% CI, 1.05 to 4.90). Obesity, family hi story, fasting plasma glucose levels, and parity were not significant risk factors. However, even without any of the significant risk factor s, logistic regression modeling suggested that a woman who has had GDM in a previous pregnancy has a 5.1% (95% CI, 2.2 to 11.6%) chance of h aving early recurrent GDM. We therefore continue to recommend that all women who have had GDM diagnosed previously should have glucose toler ance testing performed early (before 24 weeks' gestation) in any futur e pregnancies.