Janet M Catov1,2,3, Baiyang Sun2, Marnie Bertolet2, Gabrielle G Snyder2, Cora E Lewis4,5, Norrina B Allen6,7, James M Shikany4,5, Katherine H Ingram8, Duke Appiah9, Erica P Gunderson10. 1. Department of Obstetrics, Gynecology and Reproductive Sciences, School of Medicine and Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. 2. Department of Epidemiology, School of Medicine and Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA. 3. Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh Medical Center Magee-Womens Hospital, Magee-Womens Research Institute, Pittsburgh, Pennsylvania, USA. 4. Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA. 5. Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA. 6. Department of Preventative Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA. 7. Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA. 8. Department of Exercise Science and Sport Management, Kennesaw State University, Kennesaw, Georgia, USA. 9. Department of Public Health, Health Sciences Center, Texas Tech University, Lubbock, Texas, USA. 10. Cardiovascular and Metabolic Conditions Section, Division of Research, Kaiser Permanente Northern California, Oakland, California, USA.
Abstract
OBJECTIVE: This study hypothesized that both preconception and postchildbearing patterns of cardiometabolic risk factors may be different for women with gestational diabetes mellitus (GDM) compared with women without GDM. METHODS: Among 1,302 (51% black) women in the Coronary Artery Risk Development in Young Adults (CARDIA) study with births and followed for 30 years, this study evaluated changes in cardiometabolic factors (BMI, waist circumference [WC], lipids, blood pressure) during prechildbearing (prior to the first postbaseline birth) and postchildbearing periods (after the last birth) by GDM status using piecewise linear mixed models adjusted for sociodemographics, parity, and time-varying covariates. RESULTS: Compared with women who did not develop GDM, weight and WC increases in women who developed GDM (n = 152, 12%) were faster (BMI difference: +0.12 kg/m2 /y, P = 0.04; WC difference: +0.28 cm/y, P = 0.04) during the prechildbearing period, accounting for covariates. This translated to an average of 1.3 kg of excess weight gain across 4 years among women with subsequent GDM versus non-GDM births. In contrast, slopes after childbearing did not differ by GDM status, nor were there other cardiometabolic differences. CONCLUSIONS: Women with GDM exhibited an increasing prepregnancy pattern of weight gain and central adiposity. Absolute postchildbearing weight was also higher in GDM-affected women, but the slope of gain after GDM was not.
OBJECTIVE: This study hypothesized that both preconception and postchildbearing patterns of cardiometabolic risk factors may be different for women with gestational diabetes mellitus (GDM) compared with women without GDM. METHODS: Among 1,302 (51% black) women in the Coronary Artery Risk Development in Young Adults (CARDIA) study with births and followed for 30 years, this study evaluated changes in cardiometabolic factors (BMI, waist circumference [WC], lipids, blood pressure) during prechildbearing (prior to the first postbaseline birth) and postchildbearing periods (after the last birth) by GDM status using piecewise linear mixed models adjusted for sociodemographics, parity, and time-varying covariates. RESULTS: Compared with women who did not develop GDM, weight and WC increases in women who developed GDM (n = 152, 12%) were faster (BMI difference: +0.12 kg/m2 /y, P = 0.04; WC difference: +0.28 cm/y, P = 0.04) during the prechildbearing period, accounting for covariates. This translated to an average of 1.3 kg of excess weight gain across 4 years among women with subsequent GDM versus non-GDM births. In contrast, slopes after childbearing did not differ by GDM status, nor were there other cardiometabolic differences. CONCLUSIONS:Women with GDM exhibited an increasing prepregnancy pattern of weight gain and central adiposity. Absolute postchildbearing weight was also higher in GDM-affected women, but the slope of gain after GDM was not.
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