Pia Egerup1,2, Anders P Mikkelsen3, Astrid Marie Kolte4,5, David Westergaard4,6,7, Steen Rasmussen3, Filip K Knop5,8,9,10, Øjvind Lidegaard3, Henriette S Nielsen4,11,5. 1. The Recurrent Pregnancy Loss Unit, The Capital Region, Rigshospitalet and Hvidovre, Copenhagen University Hospital, Copenhagen, Denmark. piaegerup@hotmail.com. 2. Department of Obstetrics and Gynecology, Hvidovre Hospital, Copenhagen University Hospital, Kettegård Allé 30, 2650, Hvidovre, Denmark. piaegerup@hotmail.com. 3. Department of Gynecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. 4. The Recurrent Pregnancy Loss Unit, The Capital Region, Rigshospitalet and Hvidovre, Copenhagen University Hospital, Copenhagen, Denmark. 5. Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. 6. Novo Nordisk Foundation Center for Protein Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. 7. Methods and Analysis, Statistics Denmark, Copenhagen, Denmark. 8. Center for Clinical Metabolic Research, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark. 9. Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. 10. Steno Diabetes Center Copenhagen, Gentofte, Denmark. 11. Department of Obstetrics and Gynecology, Hvidovre Hospital, Copenhagen University Hospital, Kettegård Allé 30, 2650, Hvidovre, Denmark.
Abstract
AIMS/HYPOTHESIS: Type 2 diabetes is killing more people than ever, and early-life predictors remain critical for the development of effective preventive strategies. Pregnancy loss is a common event associated with later atherosclerotic disease and ischaemic heart failure and might constitute a predictor for type 2 diabetes. The objective of this study was to investigate whether pregnancy loss is associated with later development of type 2 diabetes. METHODS: Using a Danish nationwide cohort, we identified all women born from 1957 through to 1997 and who had a diagnosis of type 2 diabetes during the period 1977 to 2017. The women were matched 1:10 on year of birth and educational level to women without diabetes in the general Danish population. Conditional logistic regression models provided odds ratios for type 2 diabetes with different numbers of pregnancy losses. RESULTS: We identified 24,774 women with type 2 diabetes and selected 247,740 controls without diabetes. Women who had ever been pregnant (ever-pregnant women) with 1, 2 and ≥ 3 pregnancy losses had ORs of type 2 diabetes of 1.18 (95% CI 1.13, 1.23), 1.38 (95% CI 1.27, 1.49) and 1.71 (95% CI 1.53, 1.92) compared with ever-pregnant women with no pregnancy losses, respectively. Women who never achieved a pregnancy had an OR of type 2 diabetes of 1.56 (95% CI 1.51, 1.61) compared with ever-pregnant women with any number of losses. Similar results were found after adjustment for obesity and gestational diabetes. CONCLUSIONS/ INTERPRETATION: We found a significant and consistent association between pregnancy loss and later type 2 diabetes that increased with increasing number of losses. Thus, pregnancy loss and recurrent pregnancy loss are significant risk factors for later type 2 diabetes. Future studies should explore whether this association is due to common background factors or whether prediabetic metabolic conditions are responsible for this association. Graphical abstract.
AIMS/HYPOTHESIS: Type 2 diabetes is killing more people than ever, and early-life predictors remain critical for the development of effective preventive strategies. Pregnancy loss is a common event associated with later atherosclerotic disease and ischaemic heart failure and might constitute a predictor for type 2 diabetes. The objective of this study was to investigate whether pregnancy loss is associated with later development of type 2 diabetes. METHODS: Using a Danish nationwide cohort, we identified all women born from 1957 through to 1997 and who had a diagnosis of type 2 diabetes during the period 1977 to 2017. The women were matched 1:10 on year of birth and educational level to women without diabetes in the general Danish population. Conditional logistic regression models provided odds ratios for type 2 diabetes with different numbers of pregnancy losses. RESULTS: We identified 24,774 women with type 2 diabetes and selected 247,740 controls without diabetes. Women who had ever been pregnant (ever-pregnant women) with 1, 2 and ≥ 3 pregnancy losses had ORs of type 2 diabetes of 1.18 (95% CI 1.13, 1.23), 1.38 (95% CI 1.27, 1.49) and 1.71 (95% CI 1.53, 1.92) compared with ever-pregnant women with no pregnancy losses, respectively. Women who never achieved a pregnancy had an OR of type 2 diabetes of 1.56 (95% CI 1.51, 1.61) compared with ever-pregnant women with any number of losses. Similar results were found after adjustment for obesity and gestational diabetes. CONCLUSIONS/ INTERPRETATION: We found a significant and consistent association between pregnancy loss and later type 2 diabetes that increased with increasing number of losses. Thus, pregnancy loss and recurrent pregnancy loss are significant risk factors for later type 2 diabetes. Future studies should explore whether this association is due to common background factors or whether prediabetic metabolic conditions are responsible for this association. Graphical abstract.
Authors: Anders Pretzmann Mikkelsen; Pia Egerup; Astrid Marie Kolte; David Westergaard; Henriette Svarre Nielsen; Øjvind Lidegaard Journal: PLoS One Date: 2022-03-31 Impact factor: 3.240
Authors: Damien Foo; Jennifer Dunne; Gavin Pereira; Amanuel Gebremedhin; Bereket Duko; Gizachew A Tessema Journal: Int J Environ Res Public Health Date: 2022-07-07 Impact factor: 4.614