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Title: Maternal Educational Level and the Risk of Persistent Post-Partum Glucose Metabolism Disorders in Women with Gestational Diabetes Mellitus
Author: Gante, I
Ferreira, AC
Pestana, G
Pires, D
Amaral, N
Dores, J
Almeida, MC
Sandoval, JL
Keywords: Adult
Blood Glucose
Cohort Studies
Diabetes Mellitus, Type 2
Diabetes, Gestational
Glucose Intolerance
Glucose Metabolism Disorders
Glucose Tolerance Test
Postpartum Period
Puerperal Disorders
Retrospective Studies
Risk Factors
Young Adult
Educational Status
Issue Date: Mar-2018
Publisher: Springer
Citation: Acta Diabetol. 2018 Mar;55(3):243-251.
Abstract: AIMS: Gestational diabetes mellitus (GDM) occurs in 5-15% of pregnancies, and lower maternal educational attainment has been associated with higher risk of GDM. We aimed to determine if maternal education level is associated with persistent post-partum glucose metabolism disorders in women with GDM. METHODS: Retrospective cohort study of women with GDM followed in 25 Portuguese health institutions between 2008 and 2012. Educational attainment was categorised into four levels. Prevalence of post-partum glucose metabolism disorders (type 2 diabetes mellitus, increased fasting plasma glucose or impaired glucose tolerance) was compared and adjusted odds ratios calculated controlling for confounders using logistic regression. RESULTS: We included 4490 women diagnosed with GDM. Educational level ranged as follows: 6.8% (n = 307) were at level 1 (≤ 6th grade), 34.6% (n = 1554) at level 2 (6-9th grade), 30.4% (n = 1364) at level 3 (10-12th grade) and 28.2% (n = 1265) at level 4 (≥ university degree). At 6 weeks post-partum re-evaluation, 10.9% (n = 491) had persistent glucose metabolism disorders. Educational levels 1 and 2 had a higher probability of persistent post-partum glucose metabolism disorders when compared to level 4 (OR = 2.37 [1.69;3.32], p < 0.001 and OR = 1.39 [1.09;1.76], p = 0.008, for level 1 and 2, respectively), an association that persisted in multivariable logistic regression adjusting for confounders (level 1 OR = 2.25 [1.53;3.33], p < 0.001; level 2 OR = 1.43 [1.09;1.89], p = 0.01). CONCLUSIONS: Persistent post-partum glucose metabolism disorders are frequent in women with GDM and associated with lower maternal educational level. Interventions aimed at this risk group may contribute towards a decrease in prevalence of post-partum glucose metabolism disorders.
Peer review: yes
DOI: 10.1007/s00592-017-1090-y
Appears in Collections:NEF - Artigos

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