Women With Higher GCT Levels but NGT Have a Similarly High Risk for Glucose Intolerance Postpartum as Women With GDM.

Abstract

Context: More data are needed on the long-term postpartum metabolic risk of women with hyperglycemia in pregnancy less than gestational diabetes mellitus (GDM) based on the 2013 World Health Organization criteria.

Objective: This work aimed to determine the association of different degrees of gestational glucose intolerance (GI) on the metabolic profile and risk for GI in women and offspring 3 to 7 years postpartum.

Methods: This multicentric prospective follow-up study of the Belgian Diabetes in Pregnancy study (BEDIP-N, which was a prospective observational study) included 334 women and 296 children. Groups were stratified according to antenatal glucose challenge test (GCT) and diagnosis of GDM based on the 2013 World Health Organization criteria: normal glucose tolerant women with normal GCT (normal GCT-NGT group), NGT with abnormal GCT (abnormal GCT-NGT group), and a GDM group. Logistic regression was performed to adjust for following confounders: time since participation in BEDIP-N, ethnicity, prepregnancy body mass index (BMI), age, and current BMI.

Results: The GCT cutoff with the highest Youden index to predict GI in mothers 5.7 years postpartum was greater than or equal to 8.3 mmol/L (≥150 mg/dL). NGT women with GCT greater than or equal to 8.3 mmol/L (abnormal GCT-NGT group, n = 39) had a similarly increased risk for GI as women with GDM (n = 82) with an adjusted odds ratio of 2.87 (1.47-5.60; P = .0020) compared to the normal GCT-NGT group (n = 213). β-Cell function decreased over the different gestational glucose tolerance groups, with similar β-cell dysfunction in the GDM and abnormal GCT-NGT groups. Offspring of women with hyperglycemia less than GDM did not have an increased risk for an adverse metabolic profile postpartum.

Conclusion: NGT women with GCT greater than or equal to 8.3 mmol/L (≥150 mg/dL) in pregnancy have a similarly high risk for GI 5.7 years postpartum as women with GDM. These women also need postpartum follow-up to prevent GI.