Analysis of risk factors for the recurrence of gestational diabetes in subsequent pregnancy A nationwide population-based study in South Korea

We compared the obstetric and neonatal outcomes of women with and without gestational diabetes recurrence during subsequent pregnancy and identified the risk factors for gestational diabetes recurrence. In this nationwide population-based study, we analyzed pregnant women and their neonates delivered in Korea between January 2015 and December 2021 using the Korea National Health Insurance claims and National Health-Screening Program for Infants and Children databases. In total, 1985,678 pregnant women were analyzed, of whom 15,086 were diagnosed with gestational diabetes in their first pregnancy. By categorizing pregnant women into the gestational diabetes recurrence and nonrecurrence groups, we attempted to confirm the risk factors for gestational diabetes recurrence. Herein, 5672 and 9414 cases of gestational diabetes recurrence and nonrecurrence were analyzed. In the first and second pregnancy, maternal age and gestational age at delivery, and neonatal birthweight, were significantly different between 2 groups (P < .001). Preterm birth under 37 weeks of gestation, gestational hypertension, and neonates of large for gestational age, were also significantly more occurred in the recurrence group, compared to the nonrecurrence group (P < .001). The interval between the first and second deliveries was significantly longer in the recurrence group (P = .0016). In the multivariate analysis, recurrence of gestational diabetes was significantly associated with interpregnancy interval (adjusted odds ratios [OR], 1.008; 95% confidence interval [CI], 1.001–1.016, P = .031), presence of gestational hypertension (adjusted OR, 1.206; 95% CI, 1.015–1.432, P = .0331), earlier gestational ages at delivery (adjusted OR, 0.913; 95% CI, 0.885–0.942, P < .001) and heavier neonates (adjusted OR, 1.134; 95% CI, 1.014–1.268, P = .0272), at the first pregnancy. The factors predicting the recurrence of gestational diabetes are interpregnancy interval, gestational hypertension, earlier delivery, and neonates with higher birth weight in the first pregnancy.