Impact of gestational diabetes mellitus and high maternal weight on the development of diabetes, hypertension and cardiovascular disease: a population‐level analysis

Kaul, Padma; Savu, Anamaria; Nerenberg, Kara; Donovan, Lois; Chik, Constance L.; Ryan, Edmond A.; Johnson, Jeffrey

doi:10.1111/dme.12635

Cited by 98 publications

(88 citation statements)

References 23 publications

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“…Twenty eight cohorts reported the diagnostic criteria for GDM being used: 10 used local or self-reported criteria (19,20,22,(26)(27)(28)31,34,36,41), 3 used the World Health Organization's (WHO) 1985 criteria (17,33,40), 4 with the WHO's 1999 criteria (24,25,29,43), 3 with the Carpenter-Coustan's criteria (38,42,46), one with the ADA's 1997 criteria (30), the European Association for the Study of Diabetes' (18), the Canadian Diabetes Association's (32), the National Diabetes Data Group's (23), the Fifth International Workshop Conference on GDM's (45), Finnish Diabetes Association's (35), the Second and Third GDM Workshop Conference's (44) and the Australian Diabetes in Pregnancy Society Guidelines' (39), respectively.…”

Section: Literature Search Resultsmentioning

confidence: 99%

Long‐term risk of diabetes in women at varying durations after gestational diabetes: a systematic review and meta‐analysis with more than 2 million women

et al. 2017

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SummaryThis study aims to investigate the impact of gestational diabetes mellitus (GDM) on the long-term risks of diabetes in women with prior GDM, including the effect at different time periods after GDM. We searched PubMed and other databases to retrieve articles which were published prior to February 28, 2017. Cohort studies which evaluated the risk and time of onset of diabetes postpartum in women with and without GDM were included. Meta-analysis with random effects models was used to obtain pooled relative risks and 95% confidence intervals for the risk of diabetes. Subgroup analyses were performed to check for different effect sizes as well as consistency across groups. Multivariable logistic regression was used to adjust for confounders. Thirty cohort studies with 2,626,905 pregnant women were included. Women with prior GDM had 7.76-fold (95% confidence intervals: 5.10-11.81) unadjusted pooled risk of diabetes as compared with women without GDM, whilst the adjusted risk was 17. 92-fold (16.96-18.94). The adjusted ORs of GDM for diabetes among women at <3, ≥3 -<6 and ≥6 -<10 years after GDM were 5.37 (3.51-9.34), 16.55 (16.08-17.04) and 8.20 (4.53-14.86), respectively. Women with prior GDM had substantially increased risk of diabetes, with the risk highest during the 3-6 years after GDM.

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Section: Literature Search Resultsmentioning

confidence: 99%

Long‐term risk of diabetes in women at varying durations after gestational diabetes: a systematic review and meta‐analysis with more than 2 million women

et al. 2017

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“…Those studies were conducted in Canada (12, 23, 24), Sweden (22), and France (25). Our results, using data from a nationwide population-based study in the United States were generally consistent with those previous studies.…”

Section: Discussionmentioning

confidence: 99%

History of Gestational Diabetes Mellitus in Relation to Cardiovascular Disease and Cardiovascular Risk Factors in US Women

et al. 2017

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BackgroundFindings from previous studies examining the association between gestational diabetes mellitus (GDM) and subsequent risk of cardiovascular disease (CVD) have been inconsistent and inconclusive. We aimed to examine the associations of a previous history of GDM with risk of CVD and status of cardiovascular risk factors in a nationwide population-based study in the United States.MethodsThis study included 8,127 parous women aged 20 years or older in the 2007–2014 cycles of the National Health and Nutrition Examination Survey in the United States. The exposure was self-reported diagnostic history of GDM and the outcomes were self-reported diagnostic history of CVD and measurements of cardiovascular risk factors, including blood pressure and blood lipids. Regression models with sample weights were used to examine the associations of GDM with CVD and cardiovascular risk factors.ResultsAmong women with a history of both GDM and CVD, CVD was diagnosed on average 22.9 years after the diagnosis of GDM. After adjustment for demographic, socioeconomic, and lifestyle factors, a history of GDM was associated with 63% higher odds of CVD [odds ratio (OR) 1.63, 95% confidence interval (CI) 1.02, 2.62, p-value = 0.04]. Further adjustment for body mass index (BMI) modestly attenuated the association (OR 1.52, 95% CI 0.95, 2.44, p-value = 0.08). A history of GDM was significantly associated with lower serum level of HDL-cholesterol (adjusted β-coefficient −3.33, 95% CI −5.17, −1.50, p-value ≤ 0.001), but not associated with total cholesterol, LDL-cholesterol, triglycerides, or systolic or diastolic blood pressure. Similarly, the association between a history of GDM and HDL cholesterol was attenuated after additional adjustment for BMI (adjusted β-coefficient −1.68, 95% CI −3.38, 0.03, p-value = 0.54).ConclusionWomen with a previous history of GDM have significantly higher risk for developing CVD and lower serum level of HDL cholesterol, compared to women without a history of GDM. The associations may be explained, at least partly, by BMI.

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“…Maternal pre‐pregnancy BMI and abdominal adiposity have been shown to contribute to risk for GDM . Similarly, BMI and weight change after a pregnancy complicated by GDM are strongly tied to subsequent type 2 diabetes risk …”

Section: Discussionmentioning

confidence: 99%

Type 2 diabetes after gestational diabetes mellitus in South Asian women in the United States

Gadgil

Oza-Frank

Kandula

et al. 2017

Diabetes Metabolism Res

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Aims Gestational diabetes mellitus (GDM) is a major risk factor for type 2 diabetes. The incidence of both GDM and type 2 diabetes is exceedingly high in South Asian populations. However, the risk of type 2 diabetes after GDM in South Asian women in the United States is unknown. Methods South Asians aged 40 to 84 years without known cardiovascular disease were enrolled in a community-based cohort called Mediators of Atherosclerosis in South Asians Living in America study. A history of GDM was elicited through self-report, and type 2 diabetes was ascertained by an oral glucose tolerance test. We performed a multivariable logistic regression analysis to examine the odds of type 2 diabetes after GDM history in this cross-sectional analysis. Results About 9.7% of women in the Mediators of Atherosclerosis in South Asians Living in America study self-reported a history of GDM, and were significantly younger, with higher mean diastolic blood pressure and self-reported weight at age 20 and 40 years than women without a history of GDM. In a model adjusted for age, weight at age 40, family history of diabetes, education, income, physical activity, caloric intake, alcohol use, and cigarette smoking, women with a history of GDM had increased odds of having type 2 diabetes compared with women without GDM (OR 3.2; 95% CI 1.3, 7.5). Conclusions A history of GDM further increases the risk of type 2 diabetes in US South Asian women. Our findings underscore the importance of early postpartum screening in a population at high risk for type 2 diabetes.

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Impact of gestational diabetes mellitus and high maternal weight on the development of diabetes, hypertension and cardiovascular disease: a population‐level analysis

Cited by 98 publications

References 23 publications

Long‐term risk of diabetes in women at varying durations after gestational diabetes: a systematic review and meta‐analysis with more than 2 million women

Long‐term risk of diabetes in women at varying durations after gestational diabetes: a systematic review and meta‐analysis with more than 2 million women

History of Gestational Diabetes Mellitus in Relation to Cardiovascular Disease and Cardiovascular Risk Factors in US Women

Type 2 diabetes after gestational diabetes mellitus in South Asian women in the United States

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