Prospective study on the prevalence of persistent gestational diabetes and its risk factors

Abstract

Background: The prevalence of gestational diabetes mellitus (GDM) is clearly increasing. Postpartum carbohydrate tolerance is normalized in most cases, but the subsequent risk of developing type 2 diabetes is important.
Aim: to determine the prevalence of persistent gestational diabetes and its risk factors
Subjects: it was a prospective longitudinal study conducted at the National Institute of Nutrition of Tunis where 115 patients with GDM were involved and followed in post-partum period.
Results: mean age of patients was 33.62 years. The GDM was persistent in 8 patients (7% of the population), and 29 cases of pre-diabetes (25.2%) were noted. The study of risk factors showed that age was not related to the persistence of GDM but the history of previous GDM, marcrosomia and insulin therapy 2018were significant (p = 0.002, 0.001 and 0.004). Low socioeconomic status was associated with persistent diabetes (p = 0.01) and the absence of health insurance (p = 0.01). Depression (HADS) was greater in case of persistent GDM 15.25 vs 11.64 with p = 0.01. The possession of a glucometer was a protective factor (p =0.02) but not breastfeeding. After multivariate analysis, independent factors were history of GDM, insulin, cesarean delivery, glycemic screening at t2h> 1.88 g / l and depression were retained as independent risk factors.
Conclusions: screening of a group of women at high risk for GDM persistence is crucial for subsequent management especially those with depression during pregnancy.