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Faculty have requested this content not be shared on social media
CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
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Poster Session 1

(123) Outcomes associated with subsequent diagnosis of gestational diabetes following a pregnancy without gestational diabetes

Thursday, January 30, 2025
10:30 AM – 12:30 PM  
Objective: Gestational diabetes (GDM) affects more than 200,000 people annually in the U.S., with prevalence continuing to rise. GDM is associated with adverse perinatal outcomes. We sought to assess how a new diagnosis of GDM after a pregnancy without GDM impacts perinatal outcomes.

Study Design: This was a retrospective cohort study of pregnant persons in California between 2008-2020 with two births that were both singleton, non-anomalous, gestational ages 23-42 weeks. Included persons did not have pre-existing or gestational diabetes during an index pregnancy. We assessed perinatal outcomes associated with development of GDM in a subsequent pregnancy compared to those who did not develop GDM. Statistical analyses were performed utilizing chi squared and multivariable logistic regression with a p-value of 0.05.

Results: There were 849,908 people that met inclusion criteria, of which 58,403 (6.9%) had GDM in a subsequent pregnancy. New GDM in a subsequent pregnancy was associated with increased rates of hypertensive disorder (4.8% vs 10.5%, p< 0.001), preterm delivery < 37 weeks (5.4% vs 7.8%, p< 0.001), maternal ICU admission (0.07% vs 0.13%, p< 0.001) and severe maternal morbidity (0.9% vs 1.2%, p< 0.001). Cesarean delivery was higher among those that had no history of cesarean delivery (7.2% vs 11.5%, p< 0.001) and there were lower rates of operative vaginal delivery (3.9% vs 3.6%, p=0.009). Neonatal outcomes were also worse with GDM in the subsequent pregnancy, including macrosomia (10.5% vs 12.3%, p< 0.001), APGAR < 7 at 5 minutes (0.6% vs 0.7%, p< 0.001), neonatal ICU admission (8.1% vs 9.2%, p< 0.001), and respiratory distress syndrome (0.8% vs 1.2%, p< 0.001).

Conclusion: We found that GDM diagnosis in a subsequent pregnancy without prior GDM is associated with a higher rate of adverse outcomes. Our findings impact inter-pregnancy diabetes prevention, affect perinatal counseling, and clarify focus for maternal intervention for those with new GDM. Future studies should assess whether prevention of the interval development of GDM among a population without a prior diagnosis may improve pregnancy outcomes.