Maternal characteristics associated with recurrent gestational diabetes mellitus across three pregnancies   — ASN Events
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Maternal characteristics associated with recurrent gestational diabetes mellitus across three pregnancies   (#139)

Ning NZ Zhang 1 2 , Chih Ying CYK Ko 1 2 , Jenny JW Wright 1 , Stephanie ST Terry 1 , Robyn RB Barnes 1 , Cunjing CL Li 1 , Androulla AG Georgiou 1 , Mikey MX Xie 1 2 , Sarah SA Abdo 1 2 3 , Jeff JF Flack 1 3 , Tang TW Wong 1 2 3
  1. Diabetes Centre, Bankstown-Lidcombe Hospital, SWSLHD , Bankstown
  2. Faculty of Medicine and Health, University of New South Wales, Sydney
  3. School of Medicine, Western Sydney University, Sydney

Background 

Gestational diabetes mellitus (GDM) is associated with an increased risk of maternal and neonatal complications. Recurrence of GDM has been reported to be as high as 75% in high-risk cohorts. 

Aim 

To describe and compare the maternal characteristics in women with recurrent GDM across their first, second and third GDM-affected pregnancies.  

Methods 

We analysed de-identified prospectively collected singleton pregnancy data (1991 – 2025) from women with GDM across three pregnancies at Bankstown-Lidcombe Hospital. Maternal characteristics included maternal age, pre-pregnancy body mass index (BMI), total gestational weight gain (GWG), gestation at GDM diagnosis, fasting plasma glucose, one-hour and two-hour oral glucose tolerance test (OGTT) values, glycated haemoglobin (HbA1c) and ethnicity. Paired samples t-tests and McNemar’s test were used to assess statistical significance for continuous and categorical data respectively over subsequent pregnancies. 

Results 

Of the 6678 women with GDM, there were a total of 196 women with three GDM-affected pregnancies. Women were of a diverse range of ethnic backgrounds including Caucasian (n=46, 23.5%), Middle Eastern (n=86, 43.9%), South East Asian (n=36, 18.4%), South Asian (n=20, 10.2%) and other (n=8, 4.1%). Compared to the index GDM pregnancy, both second and third GDM pregnancies were diagnosed at an earlier gestational age and had higher pre-pregnancy BMI. Total gestational weight gain (GWG) differed significantly between the index and second pregnancy and between the index and third pregnancy but not between the second and third pregnancy. Fasting glucose and two-hour OGTT did not change significantly across the three pregnancies. One-hour OGTT values differed significantly between the index and second pregnancy (p < 0.05) and between the index and third pregnancy (p < 0.05), but not between the second and third pregnancy. HbA1c increased significantly across successive GDM pregnancies. 

Conclusion 

This study presents a unique patient cohort and to our knowledge, is the largest study analysing maternal characteristics in the same cohort of women across three consecutive GDM-affected pregnancies. Women with recurrent GDM represent a high-risk group and better understanding of the risk factors will help inform targeted interventions such as weight management and early OGTT screening.