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Chen, Ling-Wei; Soh, Shu E; Tint, Mya-Thway; Loy, See Ling; Yap, Fabian; Tan, Kok Hian; Lee, Yung Seng; Shek, Lynette Pei-Chi; Godfrey, Keith M; Gluckman, Peter D; Eriksson, Johan G; Chong, Yap-Seng; Chan, Shiao-Yng
Scientific reports, 03/2021, Volume: 11, Issue: 1Journal Article
We examined the associations of gestational diabetes mellitus (GDM) and women's weight status from pre-pregnancy through post-delivery with the risk of developing dysglycaemia impaired fasting glucose, impaired glucose tolerance, and type 2 diabetes (T2D) 4-6 years post-delivery. Using Poisson regression with confounder adjustments, we assessed associations of standard categorisations of prospectively ascertained pre-pregnancy overweight and obesity (OWOB), gestational weight gain (GWG) and substantial post-delivery weight retention (PDWR) with post-delivery dysglycaemia (n = 692). Women with GDM had a higher risk of later T2D relative risk (95% CI) 12.07 (4.55, 32.02) and dysglycaemia 3.02 (2.19, 4.16) compared with non-GDM women. Independent of GDM, women with pre-pregnancy OWOB also had a higher risk of post-delivery dysglycaemia. Women with GDM who were OWOB pre-pregnancy and had subsequent PDWR (≥ 5 kg) had 2.38 times (1.29, 4.41) the risk of post-delivery dysglycaemia compared with pre-pregnancy lean GDM women without PDWR. No consistent associations were observed between GWG and later dysglycaemia risk. In conclusion, women with GDM have a higher risk of T2D 4-6 years after the index pregnancy. Pre-pregnancy OWOB and PDWR exacerbate the risk of post-delivery dysglycaemia. Weight management during preconception and post-delivery represent early windows of opportunity for improving long-term health, especially in those with GDM.
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