A 20-Year Prospective Study of Childbearing and Incidence of Diabetes in Young Women, Controlling for Glycemia Before Conception
Open accessAbstract
OBJECTIVE—We sought to determine whether childbearing increases incidence of type 2 diabetes after accounting for preconception glycemia and gestational glucose intolerance. RESEARCH DESIGN AND METHODS—A prospective, biracial cohort was examined up to five times during 1985–2006 in the multicenter, U.S. population–based Coronary Artery Risk Development in Young Adults Study. The analysis included 2,408 women (1,226 black and 1,182 white) aged 18–30 years who were free of diabetes and had a fasting plasma glucose (FPG) <126 mg/dl at baseline. Incident diabetes was diagnosed by self-report, diabetes medication use, FPG ≥126 mg/dl, and/or plasma glucose ≥200 mg/dl after a 2-h oral glucose load. Time-dependent interim birth groups were those with zero and those with one or more births with or without gestational diabetes mellitus (GDM), stratified by baseline parity. Complementary log-log models estimated relative hazards of incident diabetes by interim births adjusted for age, race, family history of diabetes, and baseline covariates (FPG, BMI, education, smoking, and physical activity). RESULTS—Of 193 incident diabetes cases in 42,782 person-years (4.5 cases/1,000 person-years), 84 (44%) had one or more interim births. Among nulliparas at baseline, incident rates per 1,000 person-years were 3.2 (95% CI 2.4–4.1) for those with no births, 2.9 (1.8–3.9) for one or more births without GDM, and 18.4 (10.9–25.9) for one or more births with GDM; adjusted relative hazards (95% CI) were 0.9 (0.6–1.4) for one or more births without GDM and 3.8 (2.2–6.6) for one or more births with GDM versus no births. CONCLUSIONS—Childbearing did not elevate diabetes incidence among those with normal glucose tolerance during pregnancy (without GDM). GDM conferred the highest risk of developing diabetes independent of family history of diabetes and preconception glycemia and obesity.
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Women with gestational diabetes mellitus have a greater risk of type 2 diabetes as they age.
“albeit with a greater risk of T2D [56,57,58]”
From Recent Experimental Studies of Maternal Obesity, Diabetes during Pregnancy and the Developmental Origins of Cardiovascular Disease (2022) · cites this paper as [58]
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Self-citationEarly postpartum metabolic assessment in women with prior gestational diabetes
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Self-citation
- Authors
- Gunderson, E. P., Lewis, C. E., Tsai, A.-L., Chiang, V., Carnethon, M., Quesenberry, C. P., & Sidney, S.
- Affiliations
- Kaiser Permanente (US)
- University of Alabama at Birmingham (US)
- Northwestern University (US)
- Venue
- Diabetes
- Publisher
- American Diabetes Association
- Published
- 2007-12-01
- Volume
- 56
- Issue
- 12
- Pages
- 2990-2996
- ISSN
- 0012-1797 (ISSN-L)
- 1939-327X
- PMC
- PMC2952440
- OpenAlex
- W2151682843
- Cited by
- 164
- References
- 2
- Citations by year
- 2026: 5 · 2025: 10 · 2024: 7 · 2023: 13 · 2022: 8 · 2021: 15 · 2020: 11 · 2019: 9 · 2018: 7 · 2017: 12 · 2016: 15 · 2015: 9 · 2014: 8 · 2013: 5 · 2012: 5
- FWCI
- 7.43
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- American Diabetes Association
- National Institutes of Health (n01hc95095-66-0-1, n01hc48050-59-0-1, n01hc48048-58-0-1, n01hc48047-55-0-1, n01hc48049-61-0-1)
- National Heart, Lung, and Blood Institute (N01HC48050, N01 HC 95095, N01 HC048048, N01-HC-048049, N01 HC095095, N01 HC048050, N01-HC48048, N01-HC-48-049, N01 HC048047, N01-HC-480-47)
- National Institute of Diabetes and Digestive and Kidney Diseases (K01DK059944)
- 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
- type 2 diabetes incidence, childbearing, parity, gestational diabetes mellitus, young women, Coronary Artery Risk Development in Young Adults Study, black and white women
- MeSH terms
- Adult, Black or African American, Coronary Disease, Diabetes Mellitus, Type 2, Diabetic Angiopathies, Female, Humans, Longitudinal Studies, Pregnancy, Pregnancy Complications, Prospective Studies, Risk Factors, United States, Cohort Studies, Incidence, Patient Selection, Black People, White People, Diabetes Complications
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