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Study Measures Gestational Diabetes Risk

Researchers Say Risk Increases With Each Pregnancy
By
WebMD Health News
Reviewed by Laura J. Martin, MD

July 12, 2010 -- Pregnant women who develop gestational diabetes during their first pregnancy are at increased risk for developing this condition in their second or third pregnancies, a study shows.

The study, published online in the American Journal of Obstetrics & Gynecology, also  shows the risk increases with each pregnancy that is complicated by gestational diabetes.

There are about 135,000 cases of gestational diabetes in the U.S. each year, and it affects about 4% of all pregnancies, according to the American Diabetes Association.

In the new study of 65,132 pregnant women, those who had gestational diabetes during their first pregnancy had a 13.2-fold increased risk of developing gestational diabetes in their second pregnancy. 

Those who had gestational diabetes in their first pregnancy but not their second had a 6.3-fold increased risk for developing this condition during their third pregnancy, and those women who had gestational diabetes in their first and second pregnancies had close to a 26-fold increased risk for developing gestational diabetes in their third pregnancy, the study showed.

"We found that women with gestational diabetes in their first pregnancy are at higher risk of gestational diabetes in their subsequent pregnancies, and the risk for gestational diabetes increases further with subsequent pregnancies," says Darios Getahun, MD, MPH, a research scientist/epidemiologist in the Kaiser Permanente Southern California Department of Research & Evaluation in Pasadena, in an email interview with WebMD.

"This does not mean that women with a history of gestational diabetes have a 100% chance of developing the condition in subsequent pregnancies," he says. "Our findings suggest that women with a history of gestational diabetes in their first pregnancy are at increased risk of developing gestational diabetes in a subsequent pregnancy, compared to women with no prior history of gestational diabetes, and the risk increases with increasing number of pregnancies complicated by gestational diabetes."

Risk Reduction Strategies

Women with a history of gestational diabetes are at increased risk of subsequent gestational diabetes and type 2 diabetes. "Both the American College of Obstetrics and Gynecology and American Diabetes Association recommended that women at risk of type 2 diabetes should be counseled on the benefits of lifestyle modifications, which include diet modification, exercise, as well as weight reduction and maintenance," Getahun says.

That said, the researchers did not have information on lifestyle factors such as weight that may have contributed to women's increased risk for gestational diabetes.

The obesity epidemic may play a role in the high recurrence rate of gestational diabetes seen in this study, as being overweight or obese is a known risk factor for gestational diabetes. "Early identification of at-risk population and timely initiation of postpartum lifestyle intervention may help to prevent gestational diabetes and related adverse pregnancy outcomes," he says.

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