History of gestational diabetes increased risk of developing diabetes later in life by 60% (aHR 1.60, 95% CI 1.22–2.10) but was not associated with increased cardiovascular disease risk (aHR 0.93, 95% CI 0.57–1.51) in American Indian women.
Cohort (n=1,685)
Yes
Does a history of gestational diabetes increase the risk of later-life diabetes and cardiovascular disease in American Indian women?
In a large American Indian cohort, a history of gestational diabetes was significantly associated with the development of diabetes later in life, but not with cardiovascular disease, possibly due to the relatively young age of the participants.
Effect estimate: aHR 1.60 for diabetes, 0.93 for cardiovascular disease (95% CI 95% CI 1.22–2.10 for diabetes, 0.57–1.51 for cardiovascular disease)
Absolute Event Rate: 68.9% vs 43.3%
American Indian (AI) women are at high risk for pregnancy complications, including gestational diabetes (GDM). However, few large-scale studies address the relationship between cardiovascular and pregnancy health in this population. The Strong Heart Study examined cardiovascular disease in Oklahoma, Arizona, and North and South Dakota starting in 1988. Female participants were asked about their number of livebirths, lost pregnancies, and pregnancy complications. Gestational diabetes was self-reported, diabetes outside of pregnancy was directly assessed at regular intervals, and CVD morbidity and mortality outcomes were adjudicated. The analytic dataset consisted of women with at least one follow-up after a pregnancy, and with self-reported information on GDM (n = 1685). Cardiometabolic disease was examined using time-to-event analysis (proportional hazards modeling) with age as the time axis, controlling for covariates (smoking, BMI, income, education, age at first birth). Mean age at last follow-up was 59.5 years. Median parity was 4, and 135 (8.0%) women reported a history of GDM for at least one pregnancy. History of GDM was associated with a higher likelihood of diabetes later in life (adjusted hazard ratio aHR 1.60, 95% CI 1.22–2.10). History of GDM was not associated with later cardiovascular disease (aHR 0.93, 0.57–1.51). History of GDM in this large-scale American Indian cohort was associated with the development of diabetes later in life. Associations were not as strong for cardiovascular disease outcomes, possibly because many participants were still relatively young. This study highlights a contributor to chronic disease in a high-risk population not well represented in the literature.
Harville et al. (Fri,) conducted a cohort in American Indian women with at least one pregnancy and follow-up data on gestational diabetes and cardiovascular outcomes (n=1,685). History of gestational diabetes mellitus (GDM) vs. No history of GDM was evaluated on Incidence of diabetes and cardiovascular disease outcomes (coronary heart disease, heart failure, myocardial infarction, stroke, composite CVD) (aHR 1.60 for diabetes, 0.93 for cardiovascular disease, 95% CI 95% CI 1.22–2.10 for diabetes, 0.57–1.51 for cardiovascular disease). History of gestational diabetes increased risk of developing diabetes later in life by 60% (aHR 1.60, 95% CI 1.22–2.10) but was not associated with increased cardiovascular disease risk (aHR 0.93, 95% CI 0.57–1.51) in American Indian women.