Gestational diabetes mellitus and cardio-metabolic risk factors in women and children at 3 years postpartum

Abstract

Introduction Gestational diabetes mellitus (GDM) is thought to be associated with cardio-metabolic risk factor development in women and their children during the early postpartum period and early childhood. We hypothesized that these women and their children would exhibit increased abnormal cardio-metabolic risk factors three years after pregnancy. Methods Women from the Screening Tests to Predict Poor Outcomes of Pregnancy study were invited to attend a follow-up with the child from their index pregnancy at 3 years postpartum. Women and children were assessed for anthropometric measures and haemodynamic function. Fasting blood samples were obtained from women to assess lipid and glucose status. Results A total of 281 woman-child dyads participated in the 3-year follow-up, with 40 women developing GDM during their index pregnancy. Fasting serum insulin was higher in women with GDM in index pregnancy compared to those with an uncomplicated pregnancy. However, this association was mediated by early pregnancy BMI and socioeconomic index (SEI). The rate of metabolic syndrome was higher in the GDM group than the uncomplicated pregnancy group. Maternal GDM was associated with elevated maternal fasting serum triglycerides at 3 years after adjustment for early pregnancy BMI and SEI. Children exposed to GDM in utero had higher waist circumference compared to children born after an uncomplicated pregnancy, but this is mediated the above covariates. Conclusion Exposure to GDM is associated with elevated serum triglycerides in women at 3 years postpartum but other cardiometabolic outcomes in women and children appear to be mediated by early pregnancy BMI and SEI.

CYP2E1 C-1054T and 96-bp I/D genetic variations and risk of gestational diabetes mellitus in chinese women: a case-control study

“…Upregulation of placental inflammatory cytokines, oxidative stress-related genetic variants (myeloperoxidase G-463 A, CYBA C242T, CYP2E1 C-1054T, etc. ), glycation and oxidation of proteins caused by hyperglycemia were associated with unfavourable metabolic profiles, insulin resistance, increased oxidative stress, and state of chronic inflammation in patients with GDM, which might increase the risk of adverse perinatal outcomes [ 6 , 8 , 11 , 20 , 21 , 47 ]. In contrast with most of published data in literature [ 2 , 6 , 21 ], in the present study, we found that the gestational weight gain and the birth height and weight of neonates were lower, whereas the incidence of macrosomia were similar in the GDM group than in the control group.…”

The association of breast feeding for at least six months with hemodynamic and metabolic health of women and their children aged three years: an observational cohort study

“…It is possible that the women who participated in our follow-up may have had cardio-metabolic risk factors pre-pregnancy. Of the women who attended the 3 year follow-up, 22% of these women had metabolic syndrome in pregnancy [ 44 ]. However, it is likely that assessing covariates from early pregnancy such as BMI, smoking status and SEI likely also reflect pre-pregnancy status and this could be accounted for in part [ 45 , 46 ].…”

Is There a Relationship between Adverse Pregnancy Outcomes and Future Development of Atherosclerosis?

“…This is presumably the first trial utilizing multi-sectoral inventive biomarkers to assess the risk of cardiometabolic disease in women with pregestational diabetes. On this account, women with pGDM could be incorporated into follow-up programs tailored to guarantee consistent supervision, thus delivering efficient prevention of both cardiovascular disease and type 2 diabetes (DM2) [ 49 ].…”