The prevalence and risk factors of gestational diabetes mellitus recurrence: a systematic review and meta-analysis

IF 3.4 Q1 ENDOCRINOLOGY & METABOLISM

Diabetes & Metabolic Syndrome-Clinical Research & Reviews Pub Date : 2025-08-01 DOI:10.1016/j.dsx.2025.103295

Leyang Liu, Xiaoqin Pang, Jie Liu, Weiwei Liu

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引用次数: 0

Abstract

Introduction

Gestational diabetes mellitus (GDM) is a common pregnancy complication, with a significant risk of recurrence in subsequent pregnancies.

Aims

We aimed to explore the incidence and risk factors associated with the recurrence of GDM among women with a history of GDM.

Methods

We searched several databases (PubMed, Embase, Web of Science, Cochrane Library, Ovid, CINAHL, ProQuest, China Knowledge Resource Integrated Database, Wanfang Database, VIP Database, and China Biology Medicine Database) from January 1961 to June 2024. We included only population-based studies that reported on GDM recurrence or risk factors among women, and differentiated between those with and without a history of GDM recurrence.

Results

We included 31 studies, of which 27 had a low risk of bias and 4 had a medium risk of bias. The incidence of GDM recurrence was 51 % (95 %CI: 0.48–0.55). Identified risk factors for GDM recurrence included maternal age (OR = 1.32; 95 % CI: 1.12–1.54), ethnicity (OR = 1.38; 95 % CI: 1.11–1.73), parity (OR = 1.83; 95 % CI: 1.04–3.23), family history of diabetes (OR = 2.07; 95 % CI: 1.44–2.97), history of macrosomia (OR = 1.90; 95 % CI: 1.28–2.83), insulin treatment during the index pregnancy (OR = 2.09; 95 % CI: 1.63–2.68), overweight or obesity before the index pregnancy (OR = 1.88; 95 % CI: 1.39–2.56), 1-h postprandial glucose levels on oral glucose tolerance test (OGTT) during the index pregnancy (OR = 1.50; 95 % CI: 1.04–2.16), 2-h postprandial glucose levels on OGTT during the index pregnancy (OR = 2.06; 95 % CI: 1.11–3.81), two or more abnormal OGTT value at the index pregnancy (OR = 2.38; 95 % CI: 1.88–3.02), weight gain between pregnancies (OR = 2.05; 95 % CI: 1.38–3.04), overweight or obesity before the subsequent pregnancy (OR = 1.43; 95 % CI: 1.20–1.69), weight gain before OGTT during the subsequent pregnancy (OR = 1.55; 95 % CI: 1.27–1.89), and fasting blood glucose (FBG) levels in the subsequent early pregnancy (OR = 1.22; 95 % CI: 1.06–1.40).

Conclusions

The study found a high recurrence rate of GDM. Identifying risk factors highlights the need for early screening, and lifestyle interventions to reduce recurrence risk.

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妊娠期糖尿病复发的患病率和危险因素：一项系统回顾和荟萃分析

妊娠期糖尿病（GDM）是一种常见的妊娠并发症，在随后的妊娠中有显著的复发风险。目的：探讨有GDM病史的女性GDM的发病率及与复发相关的危险因素。方法检索1961年1月~ 2024年6月的PubMed、Embase、Web of Science、Cochrane Library、Ovid、CINAHL、ProQuest、中国知识资源综合数据库、万方数据库、VIP数据库、中国生物医学数据库等数据库。我们只纳入了以人群为基础的研究，这些研究报告了女性GDM复发或危险因素，并区分了有和没有GDM复发史的女性。结果纳入31项研究，其中27项为低偏倚风险，4项为中等偏倚风险。GDM复发率为51% （95% CI: 0.48 ~ 0.55）。确定的GDM复发危险因素包括产妇年龄（OR = 1.32; 95% CI: 1.12-1.54）、种族（OR = 1.38; 95% CI: 1.11-1.73）、胎次（OR = 1.83; 95% CI: 1.04-3.23）、糖尿病家族史（OR = 2.07; 95% CI: 1.44-2.97）、巨大儿史（OR = 1.90; 95% CI: 1.28-2.83）、指数妊娠期间胰岛素治疗（OR = 2.09; 95% CI: 1.63-2.68）、指数妊娠前超重或肥胖(OR = 1.88；95% CI: 1.39-2.56)，指数妊娠期间1 h餐后口服葡萄糖耐量试验（OGTT）血糖水平（OR = 1.50; 95% CI: 1.04-2.16），指数妊娠期间2 h餐后OGTT血糖水平（OR = 2.06; 95% CI: 1.11-3.81），指数妊娠期间两次或两次以上OGTT值异常（OR = 2.38; 95% CI: 1.88-3.02），妊娠期间体重增加（OR = 2.05; 95% CI: 1.38-3.04），随后妊娠前超重或肥胖(OR = 1.43；95% CI: 1.20-1.69)，随后妊娠期间OGTT前体重增加（OR = 1.55; 95% CI: 1.27-1.89），以及随后妊娠早期的空腹血糖（FBG）水平（OR = 1.22; 95% CI: 1.06-1.40）。结论GDM有较高的复发率。识别危险因素强调了早期筛查和生活方式干预以降低复发风险的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetes & Metabolic Syndrome-Clinical Research & Reviews ENDOCRINOLOGY & METABOLISM-

CiteScore

22.90

自引率

2.00%

发文量

248

审稿时长

51 days

期刊介绍： Diabetes and Metabolic Syndrome: Clinical Research and Reviews is the official journal of DiabetesIndia. It aims to provide a global platform for healthcare professionals, diabetes educators, and other stakeholders to submit their research on diabetes care. Types of Publications: Diabetes and Metabolic Syndrome: Clinical Research and Reviews publishes peer-reviewed original articles, reviews, short communications, case reports, letters to the Editor, and expert comments. Reviews and mini-reviews are particularly welcomed for areas within endocrinology undergoing rapid changes.