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Aim: To analyze the influence of ethnicity, body mass index (BMI) and gestational diabetes (GDM) severity on abnormal glucose metabolism at the early postpartum. Methods: Glucose tolerance (WHO criteria) was evaluated at 3-9 months after delivery in a group of 71 GDM women (NDDG criteria) coming from Latin America, 43 from Africa and 14 from Asia or Pacific Islands. Their glucose tolerance was compared to 1,948 European control women by prepregnancy and postpartum BMI and by GDM severity. The effect of these parameters was adjusted for age, family history of diabetes, previous gestational diabetes, gestational age at GDM diagnosis and excess gestational weight gain. Results: Postpartum glucose tolerance was abnormal in 37.3% of women. Asian-Pacific Islanders (64.3%), Latinas (62.8%) and African (50.4%) had glucose metabolism abnormalities more frequently than European (35.5%) mothers (P<0.001). There was an effect of being overweight (AOR 1.38, 95% CI 1.121.71, P<0.001), obese (2.10, 1.56-2.83, P<0.001) prepregnancy and of non-European geographic origin (1.80, 1.2-2.7, P=0.004) on postpartum impaired glucose metabolism in the adjusted analysis. The main predictors of postpartum dysglycemia were prepregnancy obesity and GDM fasting glycemia in both non-European and European groups. The effect of ethnicity disappeared when the effect of postpartum BMI (2.14, 1.61-2.84, P<0.001 of overweight; 2.31, 1.60-3.32, P<0.001 of obesity) was considered. Conclusion: The effect of body weight is stronger than that of ethnicity on postpartum dysglycemia in women with recent gestational diabetes.

The Relative Contribution of Ethnicity, Overweight and Gestational Diabetes Severity to Postpartum Abnormal Glucose Tolerance