Gestational diabetes mellitus and subsequent cardiovascular disease in a period of rising diagnoses: Cohort study
Abstract Introduction Evidence suggests that gestational diabetes mellitus (GDM) is associated with subsequent cardiovascular disease; however, it is unclear what impact changes in screening and diagnostic criteria have had on the association of GDM with long‐term outcomes such as cardiovascular dis...
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Wiley
2025-02-01
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| Series: | Acta Obstetricia et Gynecologica Scandinavica |
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| Online Access: | https://doi.org/10.1111/aogs.15022 |
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| author | Azar Mehrabadi Ya‐Hui Yu Sonia M. Grandi Robert W. Platt Kristian B. Filion |
| author_facet | Azar Mehrabadi Ya‐Hui Yu Sonia M. Grandi Robert W. Platt Kristian B. Filion |
| author_sort | Azar Mehrabadi |
| collection | DOAJ |
| description | Abstract Introduction Evidence suggests that gestational diabetes mellitus (GDM) is associated with subsequent cardiovascular disease; however, it is unclear what impact changes in screening and diagnostic criteria have had on the association of GDM with long‐term outcomes such as cardiovascular disease. The purpose of this study was to determine the association between GDM and subsequent cardiovascular disease during a period of rising gestational diabetes diagnosis in England. Specifically, associations were compared before and after 2008, when national guidelines supporting risk factor‐based screening were introduced. Material and Methods We conducted a cohort study using routinely collected data from the Clinical Practice Research Datalink linked to the Hospital Episode Statistics and Office for National Statistics databases. The study consisted of persons aged 15–45 years with a livebirth or stillbirth between 1998 and 2017 and without a history of cardiovascular disease or pre‐pregnancy diabetes mellitus. Cox proportional hazards models, with propensity score weighting using matching weights, were used to estimate adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs) for the association of GDM diagnosis in the first recorded pregnancy with subsequent cardiovascular disease. Results Among 232 315 individuals, the incidence of cardiovascular disease was 6.6 per 1000 person‐years among those with GDM and 2.2 per 1000 person‐years among those without GDM over a mean follow‐up duration of 5.8 years. The overall aHR, 95% CI was 1.91 (1.41, 2.60). Diagnosis of GDM increased over the study period, from 0.7% in 1998–99 to 5.3% in 2017. The effect size was not markedly different in the years before (1998–2007: adjusted HR 2.05, 95% CI 2.05 1.35, 3.12) and after 2008 (2008–2017: adjusted HR 1.79, 95% CI 1.15, 2.80). Conclusions There was a strong association of GDM with cardiovascular disease after accounting for social and demographic factors and multiple comorbidities, and this association was present both before and after 2008, when national gestational diabetes screening criteria were established. |
| format | Article |
| id | doaj-art-b38e413a13cb438daa038a971bb810d8 |
| institution | OA Journals |
| issn | 0001-6349 1600-0412 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Wiley |
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| series | Acta Obstetricia et Gynecologica Scandinavica |
| spelling | doaj-art-b38e413a13cb438daa038a971bb810d82025-08-20T02:09:28ZengWileyActa Obstetricia et Gynecologica Scandinavica0001-63491600-04122025-02-01104233134110.1111/aogs.15022Gestational diabetes mellitus and subsequent cardiovascular disease in a period of rising diagnoses: Cohort studyAzar Mehrabadi0Ya‐Hui Yu1Sonia M. Grandi2Robert W. Platt3Kristian B. Filion4Department of Obstetrics & Gynecology and Pediatrics Dalhousie University Halifax Nova Scotia CanadaRollins School of Public Health, Department of Epidemiology Emory University Atlanta Georgia USADalla Lana School of Public Health University of Toronto Department of Epidemiology, and Child Health Evaluative Sciences Program, The Hospital for Sick Children Toronto Ontario CanadaDepartment of Epidemiology, Biostatistics and Occupational Health McGill University Montreal Quebec CanadaDepartment of Epidemiology, Biostatistics and Occupational Health McGill University Montreal Quebec CanadaAbstract Introduction Evidence suggests that gestational diabetes mellitus (GDM) is associated with subsequent cardiovascular disease; however, it is unclear what impact changes in screening and diagnostic criteria have had on the association of GDM with long‐term outcomes such as cardiovascular disease. The purpose of this study was to determine the association between GDM and subsequent cardiovascular disease during a period of rising gestational diabetes diagnosis in England. Specifically, associations were compared before and after 2008, when national guidelines supporting risk factor‐based screening were introduced. Material and Methods We conducted a cohort study using routinely collected data from the Clinical Practice Research Datalink linked to the Hospital Episode Statistics and Office for National Statistics databases. The study consisted of persons aged 15–45 years with a livebirth or stillbirth between 1998 and 2017 and without a history of cardiovascular disease or pre‐pregnancy diabetes mellitus. Cox proportional hazards models, with propensity score weighting using matching weights, were used to estimate adjusted hazard ratios (aHRs) with 95% confidence intervals (CIs) for the association of GDM diagnosis in the first recorded pregnancy with subsequent cardiovascular disease. Results Among 232 315 individuals, the incidence of cardiovascular disease was 6.6 per 1000 person‐years among those with GDM and 2.2 per 1000 person‐years among those without GDM over a mean follow‐up duration of 5.8 years. The overall aHR, 95% CI was 1.91 (1.41, 2.60). Diagnosis of GDM increased over the study period, from 0.7% in 1998–99 to 5.3% in 2017. The effect size was not markedly different in the years before (1998–2007: adjusted HR 2.05, 95% CI 2.05 1.35, 3.12) and after 2008 (2008–2017: adjusted HR 1.79, 95% CI 1.15, 2.80). Conclusions There was a strong association of GDM with cardiovascular disease after accounting for social and demographic factors and multiple comorbidities, and this association was present both before and after 2008, when national gestational diabetes screening criteria were established.https://doi.org/10.1111/aogs.15022cardiovascular diseasecohort studygestational diabetespregnancyscreening |
| spellingShingle | Azar Mehrabadi Ya‐Hui Yu Sonia M. Grandi Robert W. Platt Kristian B. Filion Gestational diabetes mellitus and subsequent cardiovascular disease in a period of rising diagnoses: Cohort study Acta Obstetricia et Gynecologica Scandinavica cardiovascular disease cohort study gestational diabetes pregnancy screening |
| title | Gestational diabetes mellitus and subsequent cardiovascular disease in a period of rising diagnoses: Cohort study |
| title_full | Gestational diabetes mellitus and subsequent cardiovascular disease in a period of rising diagnoses: Cohort study |
| title_fullStr | Gestational diabetes mellitus and subsequent cardiovascular disease in a period of rising diagnoses: Cohort study |
| title_full_unstemmed | Gestational diabetes mellitus and subsequent cardiovascular disease in a period of rising diagnoses: Cohort study |
| title_short | Gestational diabetes mellitus and subsequent cardiovascular disease in a period of rising diagnoses: Cohort study |
| title_sort | gestational diabetes mellitus and subsequent cardiovascular disease in a period of rising diagnoses cohort study |
| topic | cardiovascular disease cohort study gestational diabetes pregnancy screening |
| url | https://doi.org/10.1111/aogs.15022 |
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