Early Postpartum Glucose Intolerance, Metabolic Syndrome and Gestational Diabetes Mellitus Determinants after Assisted Conception: A Prospective Cohort Study

Abstract

Background: This study aimed to determine the prevalence of postpartum metabolic syndrome (MetS), glucose intolerance,and the determinants, 6-12 weeks postpartum in women with assisted reproduction technology conceptiongestational diabetes mellitus diagnosis (ART-GDM) compared to women with spontaneous conception and GDMdiagnosis (SC-GDM).Materials and Methods: In this prospective cohort study, two groups consisting of 62 ART-GDM and 64 SC-GDMsingleton pregnant women were followed 6-12 weeks after delivery for postpartum MetS. Fasting glucose, 75-g 2-hOGTT, and lipid profile were assessed. Waist and hip circumference, and systolic and diastolic blood pressures (BP)were measured at postpartum. Clinical, paraclinical, and obstetric data were recorded from registry offices. The prevalenceof MetS and glucose intolerance were determined. Predictors of MetS and glucose intolerance were evaluatedby logistic regression.Results: The prevalence of postpartum MetS was 20.8% in ART-GDM women and 10.9% in SC-GDM (P=0.123).Mean postpartum BMI and systolic BP were significantly higher in the ART-GDM group (P=0.016 and P=0.027respectively). Adverse pregnancy outcomes were significantly higher in the ART-GDM group. Postpartum glucoseintolerance prevalence did not vary significantly between the groups. Family history of diabetes was a predictive factorfor postpartum MetS and glucose intolerance 6-12 weeks after delivery.Conclusion: Early postpartum MetS and glucose intolerance prevalence after assisted conception did not vary significantly;however, postpartum body mass index (BMI) and systolic BP were significantly higher in the ART-GDM group.Lifestyle modification programs and long-term health care of ART women with GDM diagnosis can be recommended.Further studies with larger sample size and longer follow-up are necessary to verify our findings.

Keywords

• assisted reproduction technology
• gestational diabetes mellitus
• glucose intolerance
• metabolic syndrome
• postpartum period