Prognosis

Subsequent pregnancies

GDM recurs in 30% to 84% of subsequent pregnancies.[22] Risk factors for recurrence are older age, increased BMI, and higher weight gain between pregnancies.[122]

Development of type 2 diabetes

GDM is associated with an 8- to 10-fold increased risk of developing type 2 diabetes.[123][124]​ A systematic review and meta-analysis found that eventually the majority of women with GDM develop type 2 diabetes.[125] Another study found that GDM predicted increased rates of type 2 diabetes, with the relative risk increasing substantially with each additional affected pregnancy.[126] Risk of type 2 diabetes did decline with time, but remained elevated for more than 35 years.[126] Women with a history of GDM should therefore be screened regularly for type 2 diabetes, even late in life.[126]

A post hoc analysis of the Diabetes Prevention Program demonstrated that predominantly middle-aged women with a self-reported history of GDM had an approximately 50% reduction in the incidence of diabetes with an intensive lifestyle program or the use of metformin compared with placebo.[127] One meta-analysis found that among women with a history of GDM, the estimated risk of developing type 2 diabetes after 10 years of follow-up was 20%, increasing to nearly 60% after 50 years.[125] The risk of developing type 2 diabetes after GDM is roughly equivalent across ethnic groups.[124]

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