Abstract

Objective To examine rates and factors associated with recurrence of gestational diabetes mellitus (GDM) among women with a history of GDM.

Research Design and Methods We conducted a systematic literature review of articles published between January 1965 and November 2006, in which recurrence rates of GDM among women with a history of GDM were reported. Factors abstracted included recurrence rates, race/ethnicity, diagnostic criteria, and when available, maternal age, parity, weight or body mass index at the initial and subsequent pregnancy, weight gain at the initial or subsequent pregnancy and between pregnancies, insulin use, gestational age at diagnosis, glucose tolerance test levels, baby birthweight and presence of macrosomia, and breast-feeding.

Results 13 studies were examined. After the index pregnancy, recurrence rates varied between 30% and 84%. Lower rates were found in non-Hispanic white (NHW) populations (30-37%) and greater rates were found in minority populations (52-69%). Exceptions were studies that included a significant proportion of both NHW and minority women and that included women who had subsequent pregnancies within one year. No other risk factors were consistently associated with recurrence of GDM across studies. The rates of future pre-existing diabetes in pregnancy, postpartum diabetes screening rates after the index pregnancy, and the average length of time between pregnancies were generally not reported.

Conclusions Recurrence of GDM was common and may vary most significantly by NHW vs. minority race/ethnicity.