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Am J Perinatol 2025; 42(10): 1249-1256
DOI: 10.1055/a-2480-5407
Original Article

Longer Interpregnancy Interval Is Associated with Gestational Diabetes Mellitus Recurrence

Tzuria Peled   *
1   Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Affiliated with the Hebrew University School of Medicine, Jerusalem, Israel
,
Daniella Federmesser   *
2   Department of Military Medicine and “Tzameret,” Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
3   Medical Corps, Israel Defense Forces, Israel
,
Eyal Mazaki
1   Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Affiliated with the Hebrew University School of Medicine, Jerusalem, Israel
,
Hen Y. Sela 
1   Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Affiliated with the Hebrew University School of Medicine, Jerusalem, Israel
,
Sorina Grisaru-Granovsky
1   Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Affiliated with the Hebrew University School of Medicine, Jerusalem, Israel
,
Misgav Rottenstreich 
1   Department of Obstetrics and Gynecology, Shaare Zedek Medical Center, Affiliated with the Hebrew University School of Medicine, Jerusalem, Israel
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Funding None.
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Abstract

Objective

This study aimed to evaluate the effect of interpregnancy interval (IPI) on the gestational diabetes mellitus (GDM) recurrence rate in the subsequent pregnancies following an initial pregnancy complicated by GDM.

Study Design

A multicenter, retrospective cohort study was conducted. The study included women diagnosed with GDM during their index pregnancy who subsequently delivered between 26 and 42 weeks of gestation from 2005 to 2021. The study population was categorized into eight groups according to their IPIs: up to 3, 3–5, 6–11, 12–17, 18–23, 24–35, 36–47, and over 48 months. We examined the recurrence rate of GDM in the different groups while comparing it to the 18–23-month group that was defined as the reference group. Statistical analyses included univariate analyses and multiple logistic regression.

Results

Out of 3,532 women who were included in the study, 1,776 (50.3%) experienced GDM recurrence in subsequent pregnancy. The recurrence rate was 44.6% for women IPI <6 months, 42.6% for women IPI of 6–11 months, 48.0% for women IPI of 12–17 months, 49.7% for women IPI of 18–23 months, 58.0% for women IPI of 24–47 months, and 62.6% for women IPI above 48 months. Multivariable logistic regression revealed that IPIs of 24–47 months and over 48 months were significantly associated with higher recurrence rates as compared with the 18–23-month reference group (adjusted odds ratio [aOR], 95% confidence interval [CI]: 1.66 [1.04–2.64] and 3.15 [1.07–9.29], respectively). This analysis also revealed other independent risk factors for GDM recurrence, including medication-controlled GDM in the index pregnancy, obesity, maternal age, parity, and gravidity.

Conclusion

Longer IPIs (over 24 months) are associated with an increased risk of GDM recurrence in subsequent pregnancies. These findings suggest that clinicians should consider IPI while managing postpartum care and planning future pregnancies for women with a history of GDM.

Key Points

  • Longer IPIs (over 24 months) are associated with an increased risk of GDM recurrence.

  • Clinicians should consider IPI while managing postpartum care for women with a history of GDM.

  • GDM A1, obesity, maternal age, parity, and gravidity were found as risk factors for GDM recurrence.

Keywords

gestational diabetes - interpregnancy interval - recurrence - postpartum management - obesity - maternal age

Authors' Contributions

T.P. and D.F.: protocol development, data collection and management, manuscript writing/editing


E.M. and H.Y.S.: protocol development, data collection, manuscript writing/editing


S.G-G.: protocol development, data collection, manuscript editing


M.R.: protocol development, data collection and management, data analysis, manuscript writing/editing


Ethical Approval

The study was approved by the institutional ethics committee (0138-24-SZMC), which is responsible for both the SZMC and BHMC. The study was performed following the principles of the Declaration of Helsinki. Data were obtained from medical records and de-identified, with no direct participation of patients; hence, informed consent was waived.

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required. This article does not contain any studies with animals performed by any of the authors. The SZMC institutional review board approved the study (0138-24-SZMC), with full waiver of informed consent due to the retrospective, observational design of the study.


* These authors contributed equally to this work.




Publikationsverlauf

Eingereicht: 01. Oktober 2024

Angenommen: 20. November 2024

Accepted Manuscript online:
21. November 2024

Artikel online veröffentlicht:
21. Dezember 2024

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