Risk factors associated with abnormal glucose tolerance in the early postpartum period among Japanese women with gestational diabetes

article i nfo Objective: To identify the risk factors associated with abnormal glucose tolerance (AGT) on the first postpartum oral glucose tolerance test (OGTT) among Japanese women with gestational diabetes (GDM). Methods: In a retrospective study, data were analyzed from women with GDM who underwent their first postpartum OGTT 6-8 weeks post partum at a center in Omura, Japan, between January 1, 2007, and December 31, 2011. Women with diabetes or impaired glucose tolerance were deemed to have postpartum AGT. The association be- tween postpartum AGT and various risk factors was analyzed. Results: Among 169 women who underwent a postpartum OGTT, 58 (34.3%) had AGT. The significant risk factors associated with postpartum AGT in univariate analysis were pre-pregnancy body mass index (P = 0.096), 1-hour plasma glucose (P = 0.006), hemoglobin A1c (P b 0.001), insulinogenic index (P = 0.05), an insulinogenic index of less than 0.4 (P = 0.006), and insulin ther- apy during pregnancy (P b 0.001). Independent risk factors identified by multivariate logistic regression models were insulinogenic index (odds ratio (OR) 0.10, 95% confidence interval (CI) 0.01-0.74; P = 0.002), an insulinogenic indexof lessthan 0.4 (OR 5.70,95%CI1.69-21.66;P= 0.005),andinsulin therapyduring pregnan- cy (OR 3.43, 95% CI 1.03-12.55; P = 0.044). Conclusion: Among Japanese women with GDM, a lower insulinogenic index and use of insulin therapy during pregnancy are associated with early postpartum AGT. © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.