E-Poster 63rd Endocrine Society of Australia Annual Scientific Meeting 2020

Gestational diabetes and future cardiovascular disease risk in women: A systematic review and meta-analysis. (#95)

Maleesa Pathirana 1 2 , Zohra S Lassi 1 2 , Anna Ali 1 2 3 , Margaret A Arstall 2 4 , Claire T Roberts 1 2 5 , Prabha H Andraweera 1 2 4
  1. Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
  2. Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia
  3. Basil Hetzel Institute, Woodville, SA, Australia
  4. Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, SA, Australia
  5. Flinders Health and Medical Research Institute, Flinders University, Bedford Park, SA, 5042

Background/Aims: Gestational diabetes mellitus (GDM) affects 1 in 7 pregnancies. Emerging evidence suggests that women who experience GDM have a higher risk of cardiovascular disease (CVD) later in life. The primary aim of this systematic review and meta-analysis was to synthesize evidence on conventional cardiovascular risk factors among women who experience GDM.


Methods: Studies were found through an electronic search of PubMed, CINAHL and EMBASE. Studies reporting on conventional cardiovascular risk factors including blood pressure, lipids, blood glucose, fasting insulin, body mass index (BMI) and metabolic syndrome (MetS) among women who experienced GDM were selected. We included studies that defined GDM based on the International Association of Diabetes and Pregnancy Study Group definition or any previous definitions. MetS was defined using the National Cholesterol Education Program Adult Treatment Panel III/World Health Organization /International Diabetes Federation definitions.

Results: A total of 190 studies were included in the review, and 129 were included in the meta-analysis. Women diagnosed with MetS in early pregnancy have a significantly higher risk of developing GDM compared to those without MetS (RR 20.51, 95% CI 5.04 to 83.55) Women with previous GDM have a significant increase in all cardiovascular risk factors, with the exception of HDL which is lower, compared to women without a history of GDM. Subgroup analyses showed that metabolic syndrome, and elevated blood pressure, total cholesterol, triglycerides and glucose are seen in women with previous GDM as early as <1 year post-partum compared to those without previous GDM.

Conclusion: Women with previous GDM have a higher risk of cardiovascular disease based on a significant increase in risk factors compared to those with no history of GDM. Some risk factors are seen as early as <1 year post-partum. Therefore, women with GDM may benefit from early screening to identify modifiable CVD risk factors.