Childbearing is associated with higher incidence of the metabolic syndrome among women of reproductive age controlling for measurements before pregnancy: the CARDIA study

Abstract

OBJECTIVE We sought to prospectively examine whether childbearing is associated with higher incidence of the metabolic syndrome (MetS) after delivery among women of reproductive age. STUDY DESIGN In 1451 nulliparas who were aged 18–30 years and free of the MetS at baseline (1985–1986) and reexamined up to 4 times during 20 years, we ascertained incident MetS defined by the National Cholesterol Education Program Adult Treatment Panel III criteria among time-dependent interim birth groups by gestational diabetes mellitus (GDM): (0 [referent], 1 non-GDM, 2 + non-GDM, 1 + GDM births). Complementary log-log models estimated relative hazards of the MetS among birth groups adjusted for race, age, and baseline and follow-up covariates. RESULTS We identified 259 incident MetS cases in 25,246 person-years (10.3/1000 person-years). Compared with 0 births, adjusted relative hazards (95% confidence interval [CI]) were 1.33 (95% CI, 0.93–1.90) for 1 non-GDM, 1.62 (95% CI, 1.16–2.26) for 2 + non-GDM (P trend = .02), and 2.43 (95% CI, 1.53–3.86) for 1 + GDM births. CONCLUSION Increasing parity is associated with future development of the MetS independent of prior obesity and pregnancy-related weight gain. Risk varies by GDM status.

MECHANISMS IN ENDOCRINOLOGY: Parity and risk of type 2 diabetes: a systematic review and dose-response meta-analysis

“…Thus, linear and nonlinear relations were both tested to quantify the association in this study. Aside from type 2 diabetes, prospective studies in populations have found an increased risk of metabolic syndrome in multiparous women compared with nulliparous (43,44). Accumulating evidence also suggests that parity is associated with a higher risk of all-cause mortality in later life, especially with cardiovascular and cerebrovascular mortality (8,45).…”

Gestational Diabetes and the Metabolic Syndrome

“…Gunderson and colleagues (2009) examined pre-pregnancy cardiometabolic risk factors and the risk of GDM in subsequent pregnancies. They found that metabolic impairment often predated the onset of GDM, and that 27% of overweight women with one or more cardiometabolic risk factors developed GDM (Gunderson et al, 2009). Normoglycemia with at least one metabolic risk factor (i.e., low plasma HDL-C and/or hyperinsulinemia) was present before pregnancy in 34% of those who developed GDM; among overweight women, the presence of any cardiometabolic feature was associated with an almost 4 times higher risk of GDM.…”

Multiparity leads to obesity and inflammation in mothers and obesity in male offspring

“…Consequently, a significant number of women in their reproductive years, including those that are pregnant, are obese or overweight (30, 31). Obesity during gestation poses a significant clinical problem since it is linked to a spectrum of maternal complications, including gestational diabetes, exaggerated inflammation, hypertension, thromboembolism, preeclamplsia, and delivery complications (26,31,55,62,69).Multiparity is a cause of weight gain in women during their reproductive years and is in fact an independent predictor of obesity (12,20). The increase in multiparity-induced obesity (MIO) has followed overall trends in obesity, since gestational weight gain is additive to prepregnancy weight and the inability to loose weight gained postpartum (51,53,54).…”

“…Multiparity is a cause of weight gain in women during their reproductive years and is in fact an independent predictor of obesity (12,20). The increase in multiparity-induced obesity (MIO) has followed overall trends in obesity, since gestational weight gain is additive to prepregnancy weight and the inability to loose weight gained postpartum (51,53,54).…”