%0 Journal Article
%T Predictors of Postpartum Glucose Tolerance Testing in Italian Women with Gestational Diabetes Mellitus
%A Carmelo Capula
%A Eusebio Chiefari
%A Anna Vero
%A Stefania Iiritano
%A Biagio Arcidiacono
%A Luigi Puccio
%A Vittorio Pullano
%A Daniela Foti
%A Antonio Brunetti
%A Raffaella Vero
%J ISRN Endocrinology
%D 2013
%R 10.1155/2013/182505
%X Postpartum screening is critical for early identification of type 2 diabetes in women previously diagnosed with gestational diabetes mellitus (GDM). Nevertheless, its rate remains disappointingly low. Thus, we plan to examine the rate of postpartum glucose tolerance test (ppOGTT) for Italian women with GDM, before and after counseling, and identify demographic, clinical, and/or biochemical predictors of adherence. With these aims, we retrospectively enrolled 1159 women with GDM, in Calabria, Southern Italy, between 2004 and 2011. During the last year, verbal and written counseling on the importance of followup was introduced. Data were analyzed by multiple regression analysis. A significant increase of the return rate was observed following introduction of the counseling [adjusted odds ratio (AOR) 5.17 (95% CI, 3.83每6.97), ]. Interestingly, previous diagnosis of polycystic ovary syndrome (PCOS) emerged as the major predictor of postpartum followup [AOR 5.27 (95% CI, 3.51每8.70), ], even after stratification for the absence of counseling. Previous diagnosis of GDM, higher educational status, and insulin treatment were also relevant predictors. Overall, our data indicate that counseling intervention is effective, even if many women fail to return, whereas PCOS represents a new strong predictor of adherence to postpartum testing. 1. Introduction Gestational diabetes mellitus (GDM) is historically defined as ※any degree of glucose intolerance with onset or first recognition during pregnancy§ [1]. Incidence of GDM is increasing worldwide for recent trends in obesity and advancing maternal age, significantly contributing to increased overall health-care and economic costs [2, 3]. Approximately 7% of all pregnancies are complicated by GDM, resulting in more than 200,000 cases annually [4每7]. Women with GDM are at high risk for short pregnancy complications, such as gestational hypertensive disorders, fetal macrosomia, shoulder dystocia, and cesarean delivery [8每10]. In addition, GDM constitutes a high risk for future type 2 diabetes mellitus (DM) and cardiovascular disease [11每13]. In particular, women with GDM, even with mild glucose intolerance, have up to seven times more risk of developing type 2 DM compared to women with normoglycemic pregnancies [13每15], thus justifying recently recommended tighter diagnostic criteria for GDM [16]. Based on the compelling evidence that lifestyle intervention can effectively prevent or delay the development of type 2 DM [17每19], early identification of women at high risk of diabetes is very important. In this regard,
%U http://www.hindawi.com/journals/isrn.endocrinology/2013/182505/