Risk stratification of women with gestational diabetes mellitus using mutually exclusive categories based on the International Association of Diabetes and Pregnancy Study Groups criteria for the development of postpartum dysglycaemia: a retrospective cohort study.

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Abstrakt

Tytuł:: Risk stratification of women with gestational diabetes mellitus using mutually exclusive categories based on the International Association of Diabetes and Pregnancy Study Groups criteria for the development of postpartum dysglycaemia: a retrospective cohort study.
Autorzy:: Dai F; Divsion of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore.
Mani H; Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore.
Nurul SR; Divsion of Obstetrics and Gynaecology, KK Women's and Children's Hospital, Singapore.
Tan KH; Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore .
Źródło:: BMJ open [BMJ Open] 2022 Feb 17; Vol. 12 (2), pp. e055458. Date of Electronic Publication: 2022 Feb 17.
Typ publikacji:: Journal Article; Research Support, Non-U.S. Gov't
Język:: English
Imprint Name(s):: Original Publication: [London] : BMJ Publishing Group Ltd, 2011-
MeSH Terms:: Diabetes, Gestational*/diagnosis
Diabetes, Gestational*/epidemiology
Pregnancy in Diabetics*
Adult ; Blood Glucose ; Female ; Glucose Tolerance Test ; Humans ; Male ; Postpartum Period ; Pregnancy ; Retrospective Studies ; Risk Assessment ; Risk Factors
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Contributed Indexing:: Keywords: diabetes in pregnancy; primary care; risk management
Substance Nomenclature:: 0 (Blood Glucose)
Entry Date(s):: Date Created: 20220218 Date Completed: 20220420 Latest Revision: 20220420
Update Code:: 20240105
PubMed Central ID:: PMC8860034
DOI:: 10.1136/bmjopen-2021-055458
PMID:: 35177456
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Objectives: Women with gestational diabetes mellitus (GDM) are more predisposed to develop postpartum diabetes mellitus (DM). This study aimed to estimate the relative risk (RR) of postpartum dysglycaemia (prediabetes and DM) using mutually exclusive categories according to the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria cut-off points in patients with GDM, so as to establish a risk-stratification method for developing GDM management strategies.
Design, Setting and Participants: In this retrospective cohort study, 942 women who had been diagnosed with GDM (IADPSG criteria) at 24-28 weeks of gestation from November 2016 to April 2018 underwent a 75 g oral glucose tolerance test (OGTT) at 6-12 weeks postpartum in a tertiary hospital of Singapore. Seven mutually exclusive categories (three one timepoint positive categories (fasting, 1 hour and 2 hours), three two timepoint positive categories (fasting+1 hour, fasting+2 hours and 1 hour+2 hours) and one three timepoint positive category (fasting+1 hour+2 hours)) were derived from the three timepoint antenatal OGTT according to the IADPSG criteria. To calculate the RRs of postpartum dysglyceamia of each mutually exclusive group, logistic regression was applied.
Results: 924 mothers with GDM, whose mean age was 32.7±4.7 years, were mainly composed of Chinese (45.4%), Malay (21.7%) and Indian (14.3%) ethnicity. The total prevalence of postnatal dysglycaemia was 16.7% at 6-12 weeks postpartum. Stratifying subjects into seven mutually exclusive categories, the RRs of the one-time, two-time and three-time positive groups of the antenatal OGTT test were 1.0 (Ref.), 2.0 (95% CI=1.3 to 3.1; p=0.001) and 6.7 (95% CI=4.1 to 10.9; p<0.001), respectively, which could be used to categorise patients with GDM into low-risk, intermediate-risk and high-risk group.
Conclusions: Mutually exclusive categories could be useful for risk stratification and early management of patients with prenatal GDM. It is plausible and can be easily translated into clinical practice.
Competing Interests: Competing interests: None declared.
(© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

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