Long-term maternal metabolic and cardiovascular phenotypes after a pregnancy complicated by mild gestational diabetes mellitus or obesity

Ashley Battarbee, Lisa Mele, Mark B. Landon, Michael Varner, Brian M. Casey, Uma Reddy, Ronald Wapner, Dwight J. Rouse, John M. Thorp, Edward Chien, George Saade, Beth A. Plunkett, Sean C. Blackwell

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To evaluate the association of mild gestational diabetes (GDM) and obesity with metabolic and cardiovascular markers 5-10 years after pregnancy. Study Design: This was a secondary analysis of 5-10 year follow-up study of a mild GDM treatment trial and concurrent observational cohort of participants ineligible for the trial with abnormal 1-hour glucose challenge test only. Participants with 2-hour glucose tolerance test at follow-up were included. The primary exposures were mild GDM and obesity. The outcomes were insulinogenic index (IGI), 1/HOMA-IR, and cardiovascular markers VEGF, VCAM-1, CD40L, GDF-15, and ST-2. Multivariable linear regression estimated the association of GDM and obesity with biomarkers. Results: Of 951 participants in the parent study, 642(68%) were included. Lower 1/HOMA-IR were observed in treated and untreated GDM groups, compared with non-GDM (mean differences -0.24, 95%CI -0.36 - 0.12 and -0.15, 95%CI -0.28 - 0.03, respectively). Lower VCAM-1 (angiogenesis) was observed in treated GDM group (mean difference -0.11, 95%CI -0.19 - 0.03). GDM was not associated with IGI or other biomarkers. Obesity was associated with lower 1/HOMA-IR (mean difference -0.42, 95%CI -0.52 - 0.32), but not other biomarkers. Conclusion: Five to ten years after delivery, prior GDM and obesity are associated with more insulin resistance but not insulin secretion or consistent cardiovascular dysfunction.

Original languageEnglish (US)
JournalAmerican Journal of Perinatology
DOIs
StateAccepted/In press - 2022
Externally publishedYes

Keywords

  • cardiovascular disease
  • diabetes
  • gestational diabetes
  • obesity
  • pregnancy

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

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