Effects of obesity and a history of gestational diabetes on the risk of postpartum diabetes and hyperglycemia in Chinese women: Obesity, GDM and diabetes risk

Objective: To evaluate the independent or combined effects of gestational diabetes (GDM) and pre-pregnancy and postpartum BMI on the odds of postpartum diabetes and hyperglycemia. Methods: The study samples included 1263 women with prior GDM and 705 women without GDM. Postpartum 1–7 years diabetes was diagnosed by the standard oral glucose tolerance test. Results: The multivariable-adjusted odds ratios among women with prior GDM, compared with those without it, were 7.52 for diabetes and 2.27 for hyperglycemia. The multivariable-adjusted odds ratios at different postpartum BMI levels (<24, 24–27.9, and ≥ 28 kg/m²) were 1.00, 2.80, and 8.08 for diabetes (P_trend < 0.001), and 1.00, 2.10, and 4.42 for hyperglycemia (P_trend < 0.001), respectively. Women with high body fat (≥31.9%) or abdominal obesity (≥85 cm) had a 2.7–6.9-fold higher odds ratio for diabetes or hyperglycemia. Women with both obesity and prior GDM had the highest risk of diabetes or hyperglycemia compared with non-obese women without GDM. Non-obese women with prior GDM had the same risk of diabetes and hyperglycemia as non-GDM women with obesity. When using Cox regression models, the results were very close to those using logistic regression models. Conclusions: Maternal prior GDM and pre-pregnancy or postpartum obesity contribute equally to postpartum diabetes and hyperglycemia risk.