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Increased risk of cardiovascular and renal disease, and diabetes for all women diagnosed with gestational diabetes mellitus in New Zealand—A national retrospective cohort study
Background Gestational diabetes mellitus increases the risk of developing type 2 diabetes. The aim of this study is to compare cardiometabolic and renal outcomes for all women in New Zealand with gestational diabetes (2001–2010) with women without diabetes, 10–20 years following delivery. Methods A...
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| Published in: | Journal of diabetes 2024-04, Vol.16 (4), p.e13535-n/a |
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| container_title | Journal of diabetes |
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| creator | Daly, Barbara M. Wu, Zhenqiang Nirantharakumar, Krishnarajah Chepulis, Lynne Rowan, Janet A. Scragg, Robert K. R. |
| description | Background
Gestational diabetes mellitus increases the risk of developing type 2 diabetes. The aim of this study is to compare cardiometabolic and renal outcomes for all women in New Zealand with gestational diabetes (2001–2010) with women without diabetes, 10–20 years following delivery.
Methods
A retrospective cohort study, utilizing a national dataset providing information for all women who gave birth between 1 January 2001 and 31 December 2010 (n = 604 398). Adolescent girls |
| doi_str_mv | 10.1111/1753-0407.13535 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_doaj_</sourceid><recordid>TN_cdi_doaj_primary_oai_doaj_org_article_f4d2b746ed1e49a292d1ec031be66005</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><doaj_id>oai_doaj_org_article_f4d2b746ed1e49a292d1ec031be66005</doaj_id><sourcerecordid>3037398296</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4885-3a04756f8727c2b412ec40dae2d72288a5acd3892d7d9bc20e15b9f0d95851103</originalsourceid><addsrcrecordid>eNqFksuO0zAUhiMEYi6wZocssWFBZ3yJE2eFhuFWNIINbNhYjn3Surhxx05adTcPwZPwSDwJTtNWDBu8iX38nU_O0Z9lzwi-IGldkpKzCc5xeUEYZ_xBdnqsPDzsWcVOsrMYFxgXZVGwx9kJE7yqRClOs1_TVgdQEQwKNv5AvkFaBWP9WkXdOxWQatMVtMohY-NAvtqVjFU1dBBR4xPjHNr4JbRDedb6Qbex3RzNIHaqs35s33cswTnb9RHZFn2GDfoOyiXl77ufV6g90AG64OMKdGfXgLSf-9Ch2PVm-yR71CgX4en-e559e__u6_XHyc2XD9Prq5uJzoXgE6ZwXvKiESUtNa1zQkHn2CigpqRUCMWVNkxU6WiqWlMMhNdVg03FBScEs_NsOnqNVwu5CnapwlZ6ZeWu4MNMqtBZ7UA2uaF1mRdgCOSVoklKQGNGaigKjHlyvR5dq75egtHQdkG5e9L7N62dy5lfy_QQXBREJMPLvSH42z6NVS5t1GmSqgXfR8kwK1klaFUk9MU_6ML3IQ11oPK8FLSgA3U5UjrNOQZojq8hWA7hkkN85BAluQtX6nj-908c-UOaEsBHYGMdbP_nk5_evhnFfwDtLt2J</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3044782626</pqid></control><display><type>article</type><title>Increased risk of cardiovascular and renal disease, and diabetes for all women diagnosed with gestational diabetes mellitus in New Zealand—A national retrospective cohort study</title><source>Wiley Open Access Journals</source><source>PubMed Central</source><creator>Daly, Barbara M. ; Wu, Zhenqiang ; Nirantharakumar, Krishnarajah ; Chepulis, Lynne ; Rowan, Janet A. ; Scragg, Robert K. R.</creator><creatorcontrib>Daly, Barbara M. ; Wu, Zhenqiang ; Nirantharakumar, Krishnarajah ; Chepulis, Lynne ; Rowan, Janet A. ; Scragg, Robert K. R.</creatorcontrib><description>Background
Gestational diabetes mellitus increases the risk of developing type 2 diabetes. The aim of this study is to compare cardiometabolic and renal outcomes for all women in New Zealand with gestational diabetes (2001–2010) with women without diabetes, 10–20 years following delivery.
Methods
A retrospective cohort study, utilizing a national dataset providing information for all women who gave birth between 1 January 2001 and 31 December 2010 (n = 604 398). Adolescent girls <15 years, women ≥50 years and women with prepregnancy diabetes were excluded. In total 11 459 women were diagnosed with gestational diabetes and 11 447 were matched (for age and year of delivery) with 57 235 unexposed (control) women. A national hospital dataset was used to compare primary outcomes until 31 May 2021.
Results
After controlling for ethnicity, women with gestational diabetes were significantly more likely than control women to develop diabetes—adjusted hazard ratio (HR) 20.06 and 95% confidence interval (CI) 18.46–21.79; a first cardiovascular event 2.19 (1.86–2.58); renal disease 6.34 (5.35–7.51) and all‐cause mortality 1.55 (1.31–1.83), all p values <.0001. The HR and 95% CI remained similar after controlling for significant covariates: diabetes 18.89 (17.36–20.56), cardiovascular events 1.79 (1.52–2.12), renal disease 5.42 (4.55–6.45), and all‐cause mortality 1.44 (1.21–1.70). When time‐dependent diabetes was added to the model, significance remained for cardiovascular events 1.33 (1.10–1.61), p = .003 and renal disease 2.33 (1.88–2.88), p < .0001 but not all‐cause mortality.
Conclusions
Women diagnosed with gestational diabetes have an increased risk of adverse cardiometabolic and renal outcomes. Findings highlight the importance of follow‐up screening for diabetes, cardiovascular risk factors, and renal disease.
Highlights
Women diagnosed with gestational diabetes were significantly more likely to develop renal disease, have a major cardiovascular event, and develop hypertension and dyslipidemia following delivery compared with women without diabetes in pregnancy.
The risk of developing type 2 diabetes for these women remains 20 times higher than for women without diabetes in pregnancy, despite knowledge of this association for over 50 years.
European women diagnosed with gestational diabetes have the highest risk of developing type 2 diabetes compared with Māori, Pacific, and Asian women.</description><identifier>ISSN: 1753-0393</identifier><identifier>EISSN: 1753-0407</identifier><identifier>DOI: 10.1111/1753-0407.13535</identifier><identifier>PMID: 38599878</identifier><language>eng</language><publisher>Melbourne: Wiley Publishing Asia Pty Ltd</publisher><subject>Adolescent ; cardiovascular disease ; Cardiovascular Diseases - diagnosis ; Cardiovascular Diseases - epidemiology ; Cardiovascular Diseases - etiology ; Cohort analysis ; Cohort Studies ; Diabetes Mellitus, Type 2 - complications ; Diabetes Mellitus, Type 2 - diagnosis ; Diabetes Mellitus, Type 2 - epidemiology ; Diabetes, Gestational - diagnosis ; Diabetes, Gestational - epidemiology ; dyslipidemia ; Female ; Gestational diabetes ; Humans ; hypertension ; Kidney diseases ; Kidney Diseases - complications ; Mortality ; New Zealand - epidemiology ; Original ; Pregnancy ; renal disease ; Retrospective Studies ; type 2 diabetes</subject><ispartof>Journal of diabetes, 2024-04, Vol.16 (4), p.e13535-n/a</ispartof><rights>2024 The Authors. published by Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.</rights><rights>2024 The Authors. Journal of Diabetes published by Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.</rights><rights>2024. This article is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c4885-3a04756f8727c2b412ec40dae2d72288a5acd3892d7d9bc20e15b9f0d95851103</cites><orcidid>0000-0003-0329-4633</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11006618/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC11006618/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,11561,27923,27924,46051,46475,53790,53792</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38599878$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Daly, Barbara M.</creatorcontrib><creatorcontrib>Wu, Zhenqiang</creatorcontrib><creatorcontrib>Nirantharakumar, Krishnarajah</creatorcontrib><creatorcontrib>Chepulis, Lynne</creatorcontrib><creatorcontrib>Rowan, Janet A.</creatorcontrib><creatorcontrib>Scragg, Robert K. R.</creatorcontrib><title>Increased risk of cardiovascular and renal disease, and diabetes for all women diagnosed with gestational diabetes mellitus in New Zealand—A national retrospective cohort study</title><title>Journal of diabetes</title><addtitle>J Diabetes</addtitle><description>Background
Gestational diabetes mellitus increases the risk of developing type 2 diabetes. The aim of this study is to compare cardiometabolic and renal outcomes for all women in New Zealand with gestational diabetes (2001–2010) with women without diabetes, 10–20 years following delivery.
Methods
A retrospective cohort study, utilizing a national dataset providing information for all women who gave birth between 1 January 2001 and 31 December 2010 (n = 604 398). Adolescent girls <15 years, women ≥50 years and women with prepregnancy diabetes were excluded. In total 11 459 women were diagnosed with gestational diabetes and 11 447 were matched (for age and year of delivery) with 57 235 unexposed (control) women. A national hospital dataset was used to compare primary outcomes until 31 May 2021.
Results
After controlling for ethnicity, women with gestational diabetes were significantly more likely than control women to develop diabetes—adjusted hazard ratio (HR) 20.06 and 95% confidence interval (CI) 18.46–21.79; a first cardiovascular event 2.19 (1.86–2.58); renal disease 6.34 (5.35–7.51) and all‐cause mortality 1.55 (1.31–1.83), all p values <.0001. The HR and 95% CI remained similar after controlling for significant covariates: diabetes 18.89 (17.36–20.56), cardiovascular events 1.79 (1.52–2.12), renal disease 5.42 (4.55–6.45), and all‐cause mortality 1.44 (1.21–1.70). When time‐dependent diabetes was added to the model, significance remained for cardiovascular events 1.33 (1.10–1.61), p = .003 and renal disease 2.33 (1.88–2.88), p < .0001 but not all‐cause mortality.
Conclusions
Women diagnosed with gestational diabetes have an increased risk of adverse cardiometabolic and renal outcomes. Findings highlight the importance of follow‐up screening for diabetes, cardiovascular risk factors, and renal disease.
Highlights
Women diagnosed with gestational diabetes were significantly more likely to develop renal disease, have a major cardiovascular event, and develop hypertension and dyslipidemia following delivery compared with women without diabetes in pregnancy.
The risk of developing type 2 diabetes for these women remains 20 times higher than for women without diabetes in pregnancy, despite knowledge of this association for over 50 years.
European women diagnosed with gestational diabetes have the highest risk of developing type 2 diabetes compared with Māori, Pacific, and Asian women.</description><subject>Adolescent</subject><subject>cardiovascular disease</subject><subject>Cardiovascular Diseases - diagnosis</subject><subject>Cardiovascular Diseases - epidemiology</subject><subject>Cardiovascular Diseases - etiology</subject><subject>Cohort analysis</subject><subject>Cohort Studies</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Diabetes Mellitus, Type 2 - diagnosis</subject><subject>Diabetes Mellitus, Type 2 - epidemiology</subject><subject>Diabetes, Gestational - diagnosis</subject><subject>Diabetes, Gestational - epidemiology</subject><subject>dyslipidemia</subject><subject>Female</subject><subject>Gestational diabetes</subject><subject>Humans</subject><subject>hypertension</subject><subject>Kidney diseases</subject><subject>Kidney Diseases - complications</subject><subject>Mortality</subject><subject>New Zealand - epidemiology</subject><subject>Original</subject><subject>Pregnancy</subject><subject>renal disease</subject><subject>Retrospective Studies</subject><subject>type 2 diabetes</subject><issn>1753-0393</issn><issn>1753-0407</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>DOA</sourceid><recordid>eNqFksuO0zAUhiMEYi6wZocssWFBZ3yJE2eFhuFWNIINbNhYjn3Surhxx05adTcPwZPwSDwJTtNWDBu8iX38nU_O0Z9lzwi-IGldkpKzCc5xeUEYZ_xBdnqsPDzsWcVOsrMYFxgXZVGwx9kJE7yqRClOs1_TVgdQEQwKNv5AvkFaBWP9WkXdOxWQatMVtMohY-NAvtqVjFU1dBBR4xPjHNr4JbRDedb6Qbex3RzNIHaqs35s33cswTnb9RHZFn2GDfoOyiXl77ufV6g90AG64OMKdGfXgLSf-9Ch2PVm-yR71CgX4en-e559e__u6_XHyc2XD9Prq5uJzoXgE6ZwXvKiESUtNa1zQkHn2CigpqRUCMWVNkxU6WiqWlMMhNdVg03FBScEs_NsOnqNVwu5CnapwlZ6ZeWu4MNMqtBZ7UA2uaF1mRdgCOSVoklKQGNGaigKjHlyvR5dq75egtHQdkG5e9L7N62dy5lfy_QQXBREJMPLvSH42z6NVS5t1GmSqgXfR8kwK1klaFUk9MU_6ML3IQ11oPK8FLSgA3U5UjrNOQZojq8hWA7hkkN85BAluQtX6nj-908c-UOaEsBHYGMdbP_nk5_evhnFfwDtLt2J</recordid><startdate>202404</startdate><enddate>202404</enddate><creator>Daly, Barbara M.</creator><creator>Wu, Zhenqiang</creator><creator>Nirantharakumar, Krishnarajah</creator><creator>Chepulis, Lynne</creator><creator>Rowan, Janet A.</creator><creator>Scragg, Robert K. R.</creator><general>Wiley Publishing Asia Pty Ltd</general><general>John Wiley & Sons, Inc</general><general>Wiley</general><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope><orcidid>https://orcid.org/0000-0003-0329-4633</orcidid></search><sort><creationdate>202404</creationdate><title>Increased risk of cardiovascular and renal disease, and diabetes for all women diagnosed with gestational diabetes mellitus in New Zealand—A national retrospective cohort study</title><author>Daly, Barbara M. ; Wu, Zhenqiang ; Nirantharakumar, Krishnarajah ; Chepulis, Lynne ; Rowan, Janet A. ; Scragg, Robert K. R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4885-3a04756f8727c2b412ec40dae2d72288a5acd3892d7d9bc20e15b9f0d95851103</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adolescent</topic><topic>cardiovascular disease</topic><topic>Cardiovascular Diseases - diagnosis</topic><topic>Cardiovascular Diseases - epidemiology</topic><topic>Cardiovascular Diseases - etiology</topic><topic>Cohort analysis</topic><topic>Cohort Studies</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Diabetes Mellitus, Type 2 - diagnosis</topic><topic>Diabetes Mellitus, Type 2 - epidemiology</topic><topic>Diabetes, Gestational - diagnosis</topic><topic>Diabetes, Gestational - epidemiology</topic><topic>dyslipidemia</topic><topic>Female</topic><topic>Gestational diabetes</topic><topic>Humans</topic><topic>hypertension</topic><topic>Kidney diseases</topic><topic>Kidney Diseases - complications</topic><topic>Mortality</topic><topic>New Zealand - epidemiology</topic><topic>Original</topic><topic>Pregnancy</topic><topic>renal disease</topic><topic>Retrospective Studies</topic><topic>type 2 diabetes</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Daly, Barbara M.</creatorcontrib><creatorcontrib>Wu, Zhenqiang</creatorcontrib><creatorcontrib>Nirantharakumar, Krishnarajah</creatorcontrib><creatorcontrib>Chepulis, Lynne</creatorcontrib><creatorcontrib>Rowan, Janet A.</creatorcontrib><creatorcontrib>Scragg, Robert K. R.</creatorcontrib><collection>Wiley Open Access Journals</collection><collection>Wiley Free Archive</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>Journal of diabetes</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Daly, Barbara M.</au><au>Wu, Zhenqiang</au><au>Nirantharakumar, Krishnarajah</au><au>Chepulis, Lynne</au><au>Rowan, Janet A.</au><au>Scragg, Robert K. R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Increased risk of cardiovascular and renal disease, and diabetes for all women diagnosed with gestational diabetes mellitus in New Zealand—A national retrospective cohort study</atitle><jtitle>Journal of diabetes</jtitle><addtitle>J Diabetes</addtitle><date>2024-04</date><risdate>2024</risdate><volume>16</volume><issue>4</issue><spage>e13535</spage><epage>n/a</epage><pages>e13535-n/a</pages><issn>1753-0393</issn><eissn>1753-0407</eissn><abstract>Background
Gestational diabetes mellitus increases the risk of developing type 2 diabetes. The aim of this study is to compare cardiometabolic and renal outcomes for all women in New Zealand with gestational diabetes (2001–2010) with women without diabetes, 10–20 years following delivery.
Methods
A retrospective cohort study, utilizing a national dataset providing information for all women who gave birth between 1 January 2001 and 31 December 2010 (n = 604 398). Adolescent girls <15 years, women ≥50 years and women with prepregnancy diabetes were excluded. In total 11 459 women were diagnosed with gestational diabetes and 11 447 were matched (for age and year of delivery) with 57 235 unexposed (control) women. A national hospital dataset was used to compare primary outcomes until 31 May 2021.
Results
After controlling for ethnicity, women with gestational diabetes were significantly more likely than control women to develop diabetes—adjusted hazard ratio (HR) 20.06 and 95% confidence interval (CI) 18.46–21.79; a first cardiovascular event 2.19 (1.86–2.58); renal disease 6.34 (5.35–7.51) and all‐cause mortality 1.55 (1.31–1.83), all p values <.0001. The HR and 95% CI remained similar after controlling for significant covariates: diabetes 18.89 (17.36–20.56), cardiovascular events 1.79 (1.52–2.12), renal disease 5.42 (4.55–6.45), and all‐cause mortality 1.44 (1.21–1.70). When time‐dependent diabetes was added to the model, significance remained for cardiovascular events 1.33 (1.10–1.61), p = .003 and renal disease 2.33 (1.88–2.88), p < .0001 but not all‐cause mortality.
Conclusions
Women diagnosed with gestational diabetes have an increased risk of adverse cardiometabolic and renal outcomes. Findings highlight the importance of follow‐up screening for diabetes, cardiovascular risk factors, and renal disease.
Highlights
Women diagnosed with gestational diabetes were significantly more likely to develop renal disease, have a major cardiovascular event, and develop hypertension and dyslipidemia following delivery compared with women without diabetes in pregnancy.
The risk of developing type 2 diabetes for these women remains 20 times higher than for women without diabetes in pregnancy, despite knowledge of this association for over 50 years.
European women diagnosed with gestational diabetes have the highest risk of developing type 2 diabetes compared with Māori, Pacific, and Asian women.</abstract><cop>Melbourne</cop><pub>Wiley Publishing Asia Pty Ltd</pub><pmid>38599878</pmid><doi>10.1111/1753-0407.13535</doi><tpages>15</tpages><orcidid>https://orcid.org/0000-0003-0329-4633</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Wiley Open Access Journals; PubMed Central |
| subjects | Adolescent cardiovascular disease Cardiovascular Diseases - diagnosis Cardiovascular Diseases - epidemiology Cardiovascular Diseases - etiology Cohort analysis Cohort Studies Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - diagnosis Diabetes Mellitus, Type 2 - epidemiology Diabetes, Gestational - diagnosis Diabetes, Gestational - epidemiology dyslipidemia Female Gestational diabetes Humans hypertension Kidney diseases Kidney Diseases - complications Mortality New Zealand - epidemiology Original Pregnancy renal disease Retrospective Studies type 2 diabetes |
| title | Increased risk of cardiovascular and renal disease, and diabetes for all women diagnosed with gestational diabetes mellitus in New Zealand—A national retrospective cohort study |
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