Mild glucose intolerance in pregnancy and risk of cardiovascular disease: a population-based cohort study
Open accessAbstract
BACKGROUND: Pregnant women commonly receive screening for gestational diabetes mellitus by use of a 50 g glucose challenge test, followed by a diagnostic oral glucose tolerance test for those whose glucose challenge test result is abnormal. Although women with gestational diabetes have an increased risk of cardiovascular disease, it is not known whether mild glucose intolerance during pregnancy is also associated with cardiovascular disease. Thus, we sought to determine whether pregnant women with an abnormal glucose challenge test result but without gestational diabetes have an increased risk of cardiovascular disease. METHODS: We conducted a retrospective population-based cohort study that included all women in Ontario aged 20-49 years with live deliveries between April 1994 and March 1998. We excluded women with pregestational diabetes. The population was stratified into 3 cohorts: women with gestational diabetes (n = 13,888); women who received an antepartum oral glucose tolerance test (suggestive of an abnormal result of the glucose challenge test) but who did not have gestational diabetes (n = 71,831); and women who did not receive an oral glucose tolerance test (suggestive of a normal result of the glucose challenge test) (n = 349,977). The primary outcome was cardiovascular disease (admission to hospital for acute myocardial infarction, coronary bypass, coronary angioplasty, stroke or carotid endarterectomy). RESULTS: Compared with women who did not receive an oral glucose tolerance test, women with gestational diabetes and women who received an oral glucose tolerance test but did not have gestational diabetes had a higher risk of cardiovascular disease over 12.3 years of median follow-up (adjusted hazard ratio [HR] for women with gestational diabetes 1.66, 95% confidence interval [CI] 1.30-2.13, p < 0.001; adjusted HR for those with an oral glucose test but not gestational diabetes 1.19, 95% CI 1.02-1.39, p = 0.03). INTERPRETATION: Mild glucose intolerance in pregnancy may be associated with an increased risk of cardiovascular disease.
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GDM is associated with postpartum metabolic perturbation and an increased risk of cardiovascular disease.
“Not surprisingly, GDM is associated with postpartum metabolic perturbation and an increased risk of CVD [57-59].”
From Gestational Diabetes Mellitus: Diagnostic Approaches and Maternal-Offspring Complications (2022) · cites this paper as [57]
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- Authors
- Retnakaran, R., & Shah, B. R.
- Affiliations
- University of Toronto (CA)
- ORCID
- Shah, B. R.
- Venue
- Canadian Medical Association Journal
- Publisher
- CMA Impact Inc.
- Published
- 2009-08-24
- Volume
- 181
- Issue
- 6-7
- Pages
- 371-376
- ISSN
- 0820-3946 (ISSN-L)
- 1488-2329
- PMC
- PMC2742157
- OpenAlex
- W2115473578
- Cited by
- 194
- References
- 37
- Citations by year
- 2026: 4 · 2025: 5 · 2024: 10 · 2023: 7 · 2022: 11 · 2021: 7 · 2020: 12 · 2019: 16 · 2018: 18 · 2017: 18 · 2016: 8 · 2015: 14 · 2014: 9 · 2013: 20 · 2012: 10
- FWCI
- 13.40
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Canadian Medical Association Journal (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Canadian Diabetes Association
- Institute for Clinical Evaluative Sciences
- Ontario Ministry of Health and Long-Term Care
- University of Toronto
- Canadian Institutes of Health Research
- Banting and Best Diabetes Centre, University of Toronto
- Topics
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
- Keywords
- gestational diabetes mellitus, cardiovascular risk, glucose challenge test, oral glucose tolerance test, prenatal screening, myocardial infarction, stroke, coronary artery disease, postpartum women
- MeSH terms
- Adult, Blood Glucose, Cardiovascular Diseases, Diabetes Mellitus, Type 2, Female, Follow-Up Studies, Glucose Tolerance Test, Humans, Middle Aged, Pregnancy, Pregnancy Complications, Retrospective Studies, Risk, Severity of Illness Index, Cohort Studies, Proportional Hazards Models, Diabetes, Gestational
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