General Obstetrics and Gynecology: ObstetricsClinical predictors for a high risk for the development of diabetes mellitus in the early puerperium in women with recent gestational diabetes mellitus☆
Section snippets
Study population and diagnosis and treatment of GDM
This retrospective study was performed with data collected in a prospective database from a cohort of women who were followed for GDM at Los Angeles County and University of Southern California Women's and Children's Hospital between January 1987 and July 1995. GDM was diagnosed with a 2-step procedure and universal screening policy.11 If risk factors for GDM or clinical signs of overt diabetes mellitus were present at the initial visit for prenatal care, early screening for GDM was performed
Results
Of 4041 pregnancies that were complicated by GDM and were delivered during the study period, 1861 of the mothers (46%) returned for diabetes mellitus testing within 1 to 4 months after delivery. Two hundred twenty-five patients were excluded from analysis because of incomplete antepartum data; 1636 pregnancies were analyzed. The women who returned for the postpartum testing were not statistically different from women who did not return, with regard to most of the maternal demographic and
Comment
Our study cohort was of sufficient size to evaluate the relative importance of multiple clinical risk factors that were related to the mother, pregnancy, and neonate for the prediction of diabetes mellitus post partum. We found 6 independent predictors that could provide useful ORs to identify women during pregnancy who were at substantial risk for diabetes mellitus in early puerperium. All predictors were either related to the degree or the duration of hyperglycemia, and all predictors were
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