Metabolic syndrome of weight change from pre‐pregnancy to 1–5 years post‐partum among Chinese women with prior gestational diabetes

Li, W.; Liu, H.; Qiao, Yijuan; Lv, F.; Zhang, S.; Wang, L.; Leng, Junhong; Qi, Lü; Tuomilehto, Jaakko; Hu, Gang

doi:10.1111/dme.12790

Cited by 10 publications

(16 citation statements)

References 28 publications

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“…Likewise, these findings may not apply to women with GDM diagnosed early in pregnancy. However, our frequency of metabolic syndrome is high and consistent with other reports in the literature 14–16 . Still, our results may not be generalizable to the full spectrum of GDM.…”

Section: Discussionsupporting

confidence: 93%

“…A subsequent report from Denmark evaluated 481 women with a previous diagnosis of GDM at a median of 9.8 years (interquartile range 6.4 – 17.2 years) after delivery and diagnosed metabolic syndrome in 38.4% 15 . Most recently, Li and colleagues reported on 1263 Chinese women with a previous diagnosis of GDM, with 23.8% of them having a diagnosis of metabolic syndrome at 1–5 years after delivery 16 . These incidence figures (23.8 – 38.4 percent) are similar to our findings (32.9%).…”

Section: Discussionmentioning

confidence: 99%

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Pregnancies After the Diagnosis of Mild Gestational Diabetes Mellitus and Risk of Cardiometabolic Disorders

Varner¹,

Rice²,

Landon³

et al. 2017

Obstetrics &Amp; Gynecology

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Objective To assess the association of subsequent pregnancy with subsequent metabolic syndrome and type II diabetes mellitus after a pregnancy complicated by mild gestational diabetes mellitus (GDM). Methods We conducted a prospective observational follow up study of women with mild GDM randomized from 2002–2007 to usual care or dietary intervention and glucose self-monitoring. Women were evaluated 5–10 years after the parent study. Participants were grouped according to the number of subsequent pregnancies (Group A, none [reference]; Group B, one; Group C, ≥ two). Serum triglycerides, glucose tolerance, HDL-cholesterol, blood pressure, and waist circumference were assessed. Metabolic syndrome was diagnosed by American Heart Association and National Heart Lung and Blood Institute criteria. Multivariable regression was used to estimate adjusted relative risks (RR) and 95% confidence intervals (CI). Results Of 905 eligible women from the original trial, 483 agreed to participate, 426 of whom were included in this analysis. Groups A, B, and C consisted of 212, 143, and 71 women, respectively. Of women with subsequent pregnancies, 32% (69/214) had another pregnancy complicated with GDM. No difference between groups was observed for metabolic syndrome (Group A, 34%; Group B, 33%; Group C, 30%). Subsequent pregnancies were associated with diabetes mellitus outside of pregnancy (Group A, 5.2%; Group B, 10.5%, RR 2.62, 95%CI 1.16–5.91; Group C, 11.3%, RR 2.83, 95%CI 1.06–7.59), and if complicated with GDM (no subsequent GDM pregnancy, RR 1.99, 95%CI 0.82–4.84; subsequent GDM pregnancy, RR 3.75, 95%CI 1.60–8.82). Conclusions In women with prior mild GDM, subsequent pregnancies did not increase the frequency of metabolic syndrome, but subsequent pregnancies with GDM increased the risk of diabetes mellitus outside of pregnancy.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Pregnancies After the Diagnosis of Mild Gestational Diabetes Mellitus and Risk of Cardiometabolic Disorders

Varner¹,

Rice²,

Landon³

et al. 2017

Obstetrics &Amp; Gynecology

View full text Add to dashboard Cite

show abstract

“…Additionally, our previous work has already demonstrated that GDM women with large weight gain from pre-pregnancy to post-partum were more likely to develop the metabolic syndrome (ref. 16 ).…”

Section: Discussionmentioning

confidence: 99%

“…All pregnant women living in the six urban districts of Tianjin have been screened for GDM at their 26–30 gestational weeks from 1999 (ref. 16 ). First, they participate in a one-hour oral glucose tolerance test (OGTT) with 50-g glucose load in their community health centers.…”

Section: Methodsmentioning

confidence: 99%

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Association between hypertensive disorders of pregnancy and the risk of postpartum hypertension: a cohort study in women with gestational diabetes

et al. 2017

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Previous studies in general people indicated that hypertensive disorders of pregnancy (HDP) increased the risk of subsequent hypertension after delivery. Some studies found that women with gestational diabetes mellitus (GDM) had an increased risk of HDP. However, very few studies have assessed the association between HDP and the risk of postpartum hypertension among GDM women. To evaluate the association between HDP and the risk of postpartum hypertension among GDM women, a retrospective cohort study was conducted in 1261 women with prior GDM at their postpartum 1–5 years using the baseline data from Tianjin Gestational Diabetes Mellitus Prevention Program. Cox regression models were applied to assess the single and joint associations of having a history of HDP, maternal pre-pregnancy Body mass index (BMI) (normal weight, overweight and obesity), and weight change from preconception to post-delivery with the risk of subsequent hypertension among the GDM women. We found that GDM women with a history of HDP, high pre-pregnancy BMI and weight gain more than 7 kg from preconception to post-delivery had an increased risk of postpartum hypertension. Joint effects analysis revealed that the positive association between a history of HDP in the index pregnancy and the risk of postpartum hypertension was consistent in GDM women with different levels of pre-pregnancy BMI or weight gain from preconception to post-delivery. In conclusion, a history of HDP, high pre-pregnancy BMI and weight gain more than 7 kg from preconception to post-delivery increase the risk of subsequent hypertension in postpartum 1–5 years among GDM women.

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Fasting and 2-hour plasma glucose, and HbA1c in pregnancy and the postpartum risk of diabetes among Chinese women with gestational diabetes

Liu

Zhang

Wang

et al. 2016

Diabetes Research and Clinical Practice

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Aims Very few studies have assessed the association of fasting and 2-hour glucose, and HbA1c during pregnancy with postpartum diabetes risk among women with prior gestational diabetes (GDM). We assessed the association of fasting glucose, 2-hour glucose and HbA1c at 26-30 gestational weeks with postpartum diabetes risk among women with prior GDM. Methods A cohort study in 1,263 GDM women at 1–5 years after delivery was performed. Cox proportional hazards regression models were used to evaluate the association of fasting and 2-hour plasma glucose, and HbA1c at 26-30 gestational weeks with the risk of diabetes at postpartum. Results The multivariable-adjusted (age, pre-pregnancy body mass index, weight gain during pregnancy, current body mass index, family history of diabetes, marital status, education, family income, smoking status, passive smoking, leisure-time physical activity, alcohol drinking, and intake of energy, saturated fat, and dietary fiber) hazard ratios of postpartum diabetes were 1.61 (95% confidence interval [CI]: 1.36–1.91) for each 1 mmol/l increase in fasting glucose during pregnancy, 1.63 (95% CI: 1.45–1.84) for each 1 mmol/l increase in 2-hour glucose during pregnancy, 2.11 (95% CI: 1.50–2.97) for each 1 unit (%) increase in HbA1c during pregnancy. When fasting glucose, 2-hour glucose and HbA1c during pregnancy were entered multivariable-adjusted model simultaneously, 2-hour glucose and HbA1c but not fasting glucose remained to be significant and positive predictors for postpartum diabetes. Conclusions For women with prior GDM, 2-hour plasma glucose and HbA1c during pregnancy are independent predictors of postpartum diabetes, but fasting plasma glucose during pregnancy is not.

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Metabolic syndrome of weight change from pre‐pregnancy to 1–5 years post‐partum among Chinese women with prior gestational diabetes

Cited by 10 publications

References 28 publications

Pregnancies After the Diagnosis of Mild Gestational Diabetes Mellitus and Risk of Cardiometabolic Disorders

Pregnancies After the Diagnosis of Mild Gestational Diabetes Mellitus and Risk of Cardiometabolic Disorders

Association between hypertensive disorders of pregnancy and the risk of postpartum hypertension: a cohort study in women with gestational diabetes

Fasting and 2-hour plasma glucose, and HbA1c in pregnancy and the postpartum risk of diabetes among Chinese women with gestational diabetes

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