History of Infertility and Risk of Gestational Diabetes Mellitus: A Prospective Analysis of 40,773 Pregnancies

Tobias, Deirdre K; Chavarro, Jorge E.; Williams, Michelle A.; Louis, Germaine M. Buck; Hu, Frank B.; Rich‐Edwards, Janet W.; Missmer, Stacey A.; Zhang, Cuilin

doi:10.1093/aje/kwt110

Cited by 50 publications

(33 citation statements)

References 41 publications

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“…Our findings are consistent with a previous analysis in the NHS II cohort of infertility and risk of gestational diabetes mellitus (GDM) in parous women [27]. Here, we found that prepregnancy infertility was associated with a 39% higher risk of GDM (RR 1.39 [95% CI 1.24, 1.57]).…”

Section: Discussionsupporting

confidence: 92%

History of infertility and risk of type 2 diabetes mellitus: a prospective cohort study

et al. 2015

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Aims/hypothesis We sought to evaluate the relationship between delayed conception and type 2 diabetes risk, given that there are plausible underlying mechanisms linking the two, including inflammation and insulin resistance. Methods Participants of the Nurses’ Health Study II prospective cohort were included if they were free of chronic disease (cardiovascular disease, type 2 diabetes, cancer) at baseline. Biennial questionnaires updated information on infertility status (>12 months attempted pregnancy), lifestyle characteristics and several health-related outcomes. Self-reported cases of diabetes were confirmed using a follow-up questionnaire. Multivariable Cox proportional hazards models were used to compute the HRs and 95% CIs). Results Incident type 2 diabetes occurred in 5,993 of the 112,106 participants over 24 years of follow-up (1989–2013). A history of infertility was reported in 27,774 (24.8%) women and was associated with a 20% greater risk of developing diabetes, compared with those never reporting infertility (HR 1.20 [95% CI 1.14, 1.28]), after adjusting for age, lifestyle factors, marital status, oral contraceptive use, family history of diabetes and BMI. Compared with women without a history of infertility, the causes of infertility associated with a higher diabetes risk were ovulation disorders (HR 1.43 [95% CI 1.29, 1.58]) and tubal factor (HR 1.34 [95% CI 1.13, 1.58]). Cervical factor (HR 1.06 [95% CI 0.81, 1.40]) and endometriosis (HR 1.06 [95% CI 0.89, 1.27]) were not associated, while male factor infertility was associated with a modestly higher diabetes risk (HR 1.15 [95% CI 1.00, 1.33]). Conclusions/interpretation These novel findings suggest a history of infertility, particularly that related to ovulation disorders and tubal blockage, is significantly associated with a higher risk of type 2 diabetes.

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Section: Discussionsupporting

confidence: 92%

History of infertility and risk of type 2 diabetes mellitus: a prospective cohort study

et al. 2015

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“…Alternatively, tubal infertility could be an intermediate marker for STIs and inflammation which may increase risk of hypertension. In addition, we have previously found positive associations between infertility due to tubal disease and risk of other cardio-metabolic conditions including gestational diabetes (24) and type 2 diabetes (Tobias, under review for publication). However, we found no relation of tubal infertility to hypertension when using a comparison group of male factor infertility.…”

Section: Discussionmentioning

confidence: 99%

Infertility, fertility treatment, and risk of hypertension

Farland

Grodstein

Srouji

et al. 2015

Fertility and Sterility

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Objective To evaluate the association between infertility and fertility treatments on subsequent risk of hypertension. Design Cohort Study Setting Nurses’ Health Study II Patients 116,430 female nurses followed from 1993 to June 2011 as part of the Nurses' Health Study II cohort. Intervention None Main Outcome Measures Self-reported, physician diagnosed hypertension Results Compared to women who never reported infertility, infertile women were at no greater risk of hypertension (multi-variable adjusted relative risk (RR) = 1.01 95% confidence interval [0.94–1.07]). Infertility due to tubal disease was associated with a higher risk of hypertension (RR=1.15 [1.01–1.31]) but all other diagnoses were not associated with hypertension risk compared to women who did not report infertility (ovulatory disorder: RR=1.03 [0.94–1.13], cervical: RR=0.88 [0.70–1.10], male factor: RR= 1.05 [0.95–1.15], other reason: RR=1.02 [0.94–1.11], reason not found: RR=1.02 [0.95–1.10]). Among infertile women there were 5,070 cases of hypertension. No clear pattern between use of fertility treatment and hypertension was found among infertile women (Clomiphene: RR =0.97 [0.90–1.04], Gonadotropin alone: RR=0.97 [0.87–1.08], IUI: RR=0.86 [0.71–1.03], IVF: RR=0.86 [0.73–1.01]). Conclusion Among this relatively young cohort of women, there was no apparent increase in hypertension risk among infertile women or among women who underwent fertility treatment in the past.

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“…Closely spaced childbearing may reflect less breast feeding and less efficient use of contraception and be associated with other health behaviours and socioeconomic status. Very long intervals may be a consequence of poor parental health status, impaired fecundity or partnership breakdown, [21][22][23][24] all of which have implications for later health.…”

Section: Introductionmentioning

confidence: 99%

Do short birth intervals have long-term implications for parental health? Results from analyses of complete cohort Norwegian register data

Grundy

Kravdal

2014

J Epidemiol Community Health

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BackgroundShort and very long interbirth intervals are associated with worse perinatal, infant and immediate maternal outcomes. Accumulated physiological, mental, social and economic stresses arising from raising children close in age may also mean that interbirth intervals have longer term implications for the health of mothers and fathers, but few previous studies have investigated this.MethodsDiscrete-time hazards models were estimated to analyse associations between interbirth intervals and mortality risks for the period 1980–2008 in complete cohorts of Norwegian men and women born during 1935–1968 who had had two to four children. Associations between interbirth intervals and use of medication during 2004–2008 were also analysed using ordinary least-squares regression. Covariates included age, year, education, age at first birth, parity and change in coparent since the previous birth.ResultsMothers and fathers of two to three children with intervals between singleton births of less than 18 months, and mothers of twins, had raised mortality risks in midlife and early old age relative to parents with interbirth intervals of 30–41 months. For parents with three or four children, longer average interbirth intervals were associated with lower mortality. Short intervals between first and second births were also positively associated with medication use. Very long intervals were not associated with raised mortality or medication use when change of coparent since the previous birth was controlled.ConclusionsClosely spaced and multiple births may have adverse long-term implications for parental health. Delayed entry to parenthood and increased use of fertility treatments mean that both are increasing, making this a public health issue which needs further investigation.

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History of Infertility and Risk of Gestational Diabetes Mellitus: A Prospective Analysis of 40,773 Pregnancies

Cited by 50 publications

References 41 publications

History of infertility and risk of type 2 diabetes mellitus: a prospective cohort study

History of infertility and risk of type 2 diabetes mellitus: a prospective cohort study

Infertility, fertility treatment, and risk of hypertension

Do short birth intervals have long-term implications for parental health? Results from analyses of complete cohort Norwegian register data

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