Gestational Diabetes Mellitus and Obesity are Related to Persistent Hyperglycemia in the Postpartum Period

Abstract Objective To evaluate the obstetric and sociodemographic characteristics of gestational diabetic women who maintained hyperglycemia in the postpartum period (6-12 weeks postpartum). Methods This is a longitudinal cohort study with women who have had gestational diabetes and/or macrosomic children between March 1st, 2016 and March 1st, 2017. Between 6 and 12 weeks after birth, women who had gestational diabetes collected fasting glycemia, glucose tolerance test, and glycated hemoglobin results. The data were collected from medical records and during an interview in the first postpartum consultation. A statistical analysis was performed using frequency, percentage, Chi- Squared test, Fisher exact test, Mann-Whitney test, and multivariate Poisson regression. The significance level adopted for the statistical tests was 5%. Results One hundred and twenty-two women were included. Most of the women were younger than 35 years old (70.5%), white, multiparous, and with no history of gestational diabetes. Thirteen percent of the participants developed persistent hyperglycemia. A univariate analysis showed that maternal age above 35 years, being overweight, having grade 1 obesity and weight gain under 5 kg was related to the persistence of hyperglycemia in the postpartum period. Conclusion Maternal age above 35 years, obesity and overweight, and the diagnosis of gestational diabetes in the first trimester of pregnancy are associated with hyperglycemia during the postpartum period.

摘要 目的：评估产后6~12周仍持续高血糖的妊娠糖尿病女性的产科及社会人口学特征。
方法：本研究为一项纵向队列研究，研究对象为2016年3月1日至2017年3月1日期间确诊妊娠糖尿病或分娩巨大儿的女性。在产后6至12周时，对曾患妊娠糖尿病的受试者采集空腹血糖、糖耐量试验及糖化血红蛋白检测数据。数据来源于医疗记录及产后首次复诊访谈。本研究采用频数、百分比、卡方检验、费希尔精确检验、曼-惠特尼检验及多因素泊松回归进行统计学分析，设定显著性水准为5%。
结果：本研究共纳入122名女性。其中70.5%的受试者年龄低于35岁，多为白人、经产妇且无妊娠糖尿病既往史。13%的参与者出现产后持续性高血糖。单因素分析显示，母亲年龄超过35岁、超重、1级肥胖及孕期体重增长低于5kg，与产后高血糖持续存在具有相关性。
结论：母亲年龄超过35岁、肥胖与超重，以及妊娠早期确诊妊娠糖尿病，与产后高血糖存在显著关联。