Advance in research on postpartum outcome and follow-up of women with gestational diabetes mellitus

Gestational diabetes mellitus (GDM) is a condition in which glucose intolerance is initially recognised during pregnancy, when the progressive increases in insulin resistance cannot be adequately accommodated by an additional pancreatic β-cell response, and it is a common complication during pregnancy. Hyperglycaemia during pregnancy can lead to adverse short-term and long-term outcomes for the mother and child. It may cause deformity, stillbirth and miscarriage in the early pregnancy. In the late pregnancy, undesirable results such as giant babies, caesarean section, shoulder dystocia, neonatal transfer to paediatrics and neonatal hypoglycaemia can occur. In addition, GDM is associated with an increased risk for long-term maternal complications such as type 2 diabetes mellitus and cardiovascular disease and components of metabolic syndrome, including central obesity, hypertriglyceridemia, low HDL levels and hypertension. Glycaemic control can modify the risk for GDM recurrence in subsequent pregnancy. With the change of lifestyle and the development of economy, the prevalence of GDM increases. Although relevant domestic and foreign guidelines recommend blood glucose screening during postpartum follow-up, the time and method of screening recommended by each guideline are not uniform. Multiple barriers are identified when receiving postpartum screening, such as the lack of a physician order for the postpartum glucose test and failure by the woman to obtain the glucose test. The follow-up rate is generally low, which makes timely management of high-risk women difficult. Moreover, the postpartum results are not optimistic. Complete blood glucose screening amongst pregnant women with gestational diabetes before discharge after delivery, reminding after delivery timely, paying attention to the propaganda and education of patients and enhancing the responsibility awareness of doctor can improve the postpartum follow-up status of women with gestational diabetes and provide interventions to improve their future outcomes. This paper reviews the research progress of postpartum outcome and follow-up of women with GDM.