Gestational Diabetes

Women who deal with gestational diabetes in their first or second pregnancy are far more likely to develop the condition again in their third pregnancy, according to a new study from Kaiser Permanente that examined the electronic medical records of 65,132 women. The study was published online in the American Journal of Obstetrics and Gynecology last month.

Gestational diabetes, an expectant mother’s temporary battle with high blood sugar, complicates some seven percent of U.S. pregnancies. It poses a host of risks to both mother and child, including eventual development of type 2 diabetes and early delivery for the mothers. For children, it can lead to obesity and diabetes of their own.

The study examined both the recurrence of gestational diabetes mellitus (GDM) and the effect of racial and ethic factors on its recurrence. Among the notable findings: Mothers with GDM in their first pregnancy but not in their second had a much higher risk of developing it in their third pregnancy: That risk was an eye-popping 630 percent higher than for women without a diabetes history. Women with the disease in both their first and second pregnancies had an even higher risk for their third.

Women who had GDM in their first pregnancy had a 41.3 percent chance of developing it in their second, compared with a 4.2 percent chance for women without the disease history. In addition, Hispanic and Asian Pacific Islander women had a higher diabetes recurrence risk than white women.

“Because of the silent nature of gestational diabetes, it is important to identify early those who are at risk and watch them closely during their prenatal care,” said Darios Getahun of the Kaiser Permanente Southern California Department of Research & Evaluation, and the study’s lead author. “Well-controlled gestational diabetes may prevent complications that result in fetal and maternal morbidity, such as high blood pressure during pregnancy, urinary tract infections, cesarean delivery, big babies, birth trauma, and a variety of other adverse outcomes.”

Kaiser Permanente’s findings underscore the importance of informing pregnant women about the risks of gestational diabetes recurring and the need to find ways to treat the condition effectively.

“Clinicians should be aware and counsel potential pregnant women about their increased risk and that early detection and initiation of treatment is important because unrecognized or untreated gestational diabetes is likely to lead to adverse maternal and fetal outcomes,” Getahun said.

Kaiser Permanente is conducting ongoing research into gestational diabetes and ways to treat and reduce it. Earlier findings linked expectant mothers’ weight gain to the development of GDM. Another study found that treating gestational diabetes in mothers reduced their children’s obesity risk.

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