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Maternal and Child Health Journal
Published in: Maternal and Child Health Journal 10/2015

01-10-2015

Estimating the Recurrence Rate of Gestational Diabetes Mellitus (GDM) in Massachusetts 1998–2007: Methods and Findings

Authors: Lucinda England, Milton Kotelchuck, Hoyt G. Wilson, Hafsatou Diop, Paul Oppedisano, Shin Y. Kim, Xiaohui Cui, Carrie K. Shapiro-Mendoza

Published in: Maternal and Child Health Journal | Issue 10/2015

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Abstract

Objectives

Women with gestational diabetes mellitus (GDM) may be able to reduce their risk of recurrent GDM and progression to type 2 diabetes mellitus through lifestyle change; however, there is limited population-based information on GDM recurrence rates.

Methods

We used data from a population of women delivering two sequential live singleton infants in Massachusetts (1998–2007) to estimate the prevalence of chronic diabetes mellitus (CDM) and GDM in parity one pregnancies and recurrence of GDM and progression from GDM to CDM in parity two pregnancies. We examined four diabetes classification approaches; birth certificate (BC) data alone, hospital discharge (HD) data alone, both sources hierarchically combined with a diagnosis of CDM from either source taking priority over a diagnosis of GDM, and both sources combined including only pregnancies with full agreement in diagnosis. Descriptive statistics were used to describe population characteristics, prevalence of CDM and GDM, and recurrence of diabetes in successive pregnancies. Diabetes classification agreement was assessed using the Kappa statistic. Associated maternal characteristics were examined through adjusted model-based t tests and Chi square tests.

Results

A total of 134,670 women with two sequential deliveries of parities one and two were identified. While there was only slight agreement on GDM classification across HD and BC records, estimates of GDM recurrence were fairly consistent; nearly half of women with GDM in their parity one pregnancy developed GDM in their subsequent pregnancy. While estimates of progression from GDM to CDM across sequential pregnancies were more variable, all approaches yielded estimates of ≤5 %. The development of either GDM or CDM following a parity one pregnancy with no diagnosis of diabetes was <3 % across approaches. Women with recurrent GDM were disproportionately older and foreign born.

Conclusion

Recurrent GDM is a serious life course public health issue; the inter-pregnancy interval provides an important window for diabetes prevention.
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Metadata
Title
Estimating the Recurrence Rate of Gestational Diabetes Mellitus (GDM) in Massachusetts 1998–2007: Methods and Findings
Authors
Lucinda England
Milton Kotelchuck
Hoyt G. Wilson
Hafsatou Diop
Paul Oppedisano
Shin Y. Kim
Xiaohui Cui
Carrie K. Shapiro-Mendoza
Publication date
01-10-2015
Publisher
Springer US
Published in
Maternal and Child Health Journal / Issue 10/2015
Print ISSN: 1092-7875
Electronic ISSN: 1573-6628
DOI
https://doi.org/10.1007/s10995-015-1750-x

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