Diabète gestationnel : devenir des mères après la grossesse et de leurs enfants

In immediate post-partum, 16 to 42% of women at risk and with gestational diabetes mellitus (GDM) according to the new diagnostic criteria have dysglycemia; and 26% of them have developed incident dysglycemia at 5 years (vs. 4% of those without GDM). Eleven percent of women have diabetes 8-12 years after the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study. Cardiovascular events in women with previous GDM are twice more frequent than in women without, independently for glycemic status. Follow-up of children 8-12 years after the HAPO study show that they have a 21% higher risk for overweight or obesity when their mother had GDM than when she had not, after adjustment for confounding factors. Their cardiovascular risk is probably increased, with a higher prevalence of classical cardiovascular risk factors, and abnormalities of cardiovascular surrogates. Finally, cognitive development appears to be altered in case of maternal GDM. GDM should be considered as an opportunity for preventive initiatives.