Early postpartum metabolic syndrome in women with or without gestational diabetes: Results from Life after Gestational Diabetes Ahvaz cohort study

Diabetes Metab Syndr. 2018 May;12(3):317-323. doi: 10.1016/j.dsx.2017.12.027. Epub 2017 Dec 22.

Abstract

Aims: This study aimed to determine the prevalence rate of metabolic syndrome and its potential risk factors, 6-12 weeks postpartum in women with GDM compared to women with normal glucose tolerance.

Methods: LAGAs is an ongoing population-based prospective cohort study that started in March 2015 in Ahvaz, Iran. During 11 months of study progression, 176 women with GDM pregnancy and 86 healthy women underwent a fasting glucose test, 75-g OGTT and fasting lipid tests at 6-12 weeks postpartum. GDM was defined based on IADPSG criteria. Postpartum glucose intolerance was defined according to ADA criteria and metabolic syndrome using 2 sets of criteria.

Results: The overall rate of metabolic syndrome at 6-12 weeks postpartum was 16% by NCEP-ATP III criteria (18.2% in women with GDM and 11.6% in controls) and 19.1% by IDF criteria (21% in women with gestational diabetes and 15.1% in controls). Pre-pregnancy overweight or obesity, (OR 1.89, 95% CI: 1.05-3.38, P = .03), pregnancy systolic blood pressure (OR 1.03, 95% CI: 1.008-1.52, P = .006) and requiring insulin or metformin (OR 3.08, 95% CI: 1.25-7.60, P = 0.01), were associated risk factors for the presence of MetS in GDM-exposed women. In women with normal glucose during pregnancy, pre-pregnancy BMI ≥25 kg/m2 was a risk factor of metabolic syndrome (OR 2.82, 95% CI: 1.11-7.15, P = .02).

Conclusion: The rate of metabolic syndrome in women with or without GDM at 6-12 weeks postpartum is high particularly in women with high BMI. An early postpartum prevention and screening program for cardiovascular risk factors is important for women with GDM.

Keywords: Cardiovascular risk factors; Gestational diabetes mellitus; LAGAs; Metabolic syndrome; Obesity.

MeSH terms

  • Adult
  • Case-Control Studies
  • Diabetes, Gestational / physiopathology*
  • Female
  • Follow-Up Studies
  • Glucose Intolerance*
  • Glucose Tolerance Test
  • Humans
  • Metabolic Syndrome / epidemiology*
  • Postpartum Period*
  • Pregnancy
  • Prevalence
  • Prognosis
  • Prospective Studies
  • Risk Factors