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

Abstract

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.

Alterations in the structural characteristics of rectus abdominis muscles caused by diabetes and pregnancy: A comparative study of the rat model and women

“…Increased risk of adverse pregnancy outcomes such as the increased risk of developing metabolic syndrome or diabetes, traumatic delivery complications, macrosomia, stillbirths, and congenital anomalies are associated with GDM [35][36][37]. The consequences of GDM for https://doi.org/10.1371/journal.pone.0231096.g002…”

Metabolic syndrome and time to pregnancy: a retrospective study of nulliparous women

“…Metabolic syndrome (MetS) in the adult population is consistently associated with cardiovascular and related diseases . We have recently shown that using the same cohort, women with MetS in pregnancy were at an increased risk for pre‐eclampsia (RR 1.63; 95% CI 1.23–2.15) and gestational diabetes (RR 3.71; 95% CI 2.42–5.67); such pregnancy complications are associated with an increased risk for CVD in adulthood . Our data suggest that MetS may be used to broadly identify women who are at increased risk for delayed fertility, whether they are obese or not.…”

Impact of gestational diabetes mellitus diagnosed during the third trimester on pregnancy outcomes: A case control study

“…Second, the long-term prognoses of both mothers and children have not been studied. Pregnant women with GDM are at increased risk for metabolic syndrome (20), type 2 diabetes (21), and cardiovascular disease (22). GDM is also considered to affect future metabolic abnormalities and neurodevelopmental prognoses of children (23)(24)(25)(26).…”