A Diabetic Pregnancy and the Heart

Gestational diabetes may be atherosclerosis risk factor all on its own

(RxWiki News) Among the complications that can occur during a pregnancy is gestational diabetes. Though gestational diabetes usually goes away after pregnancy, its risks may not always.

A recent study found that women who had gestational diabetes were more likely to have slightly thicker arteries years later than women who did not have this pregnancy complication.

The risk of atherosclerosis occurred among women with gestational diabetes even separately from their age, race or pre-pregnancy weight.

Atherosclerosis is a hardening of the arteries caused by a build-up of fat, cholesterol and other substances. It can contribute to heart disease.

"Attend all prenatal appointments."

This study, led by Erica P. Gunderson, PhD, MPH, of Kaiser Permanente Northern California, aimed to learn whether having gestational diabetes might increase the risk of later atherosclerosis.

Past research has already shown that gestational diabetes increases the risk of later type 2 diabetes, which can then increase the risk of heart disease. However, it has not been clear whether gestational diabetes might increase the risk of atherosclerosis separately from being obese or having metabolic syndrome (both risk factors for type 2 diabetes).

Metabolic syndrome is a collection of five health characteristics that predict a higher risk for type 2 diabetes.

Dr. Gunderson and colleagues tracked 898 women who were enrolled in a long-term study related to heart disease.

None of these women had type 2 diabetes or heart disease at the start of the study, which was in 1985 and 1986.

All these women gave birth to at least one child since then and had their arteries' thickness measured in 2005 and 2006.

So the researchers compared the women based on those measurements and whether they had had gestational diabetes during any of their pregnancies.

To eliminate other characteristics that might interfere with the results, the researchers adjusted their analysis to account for differences among the women's age, race, number of children and heart disease risk factors before pregnancy.

They also took into account the extent to which weight gain, insulin resistance (a feature related to diabetes) and blood pressure might affect their risk.

Among the women, 13 percent reported having gestational diabetes.

The researchers found that those who had gestational diabetes did have slightly thicker average artery measurements (0.023 mm), but when they took into account the women's weight before pregnancy, the difference dropped to 0.016 mm.

When the researchers compared only the 777 women who did not have type 2 diabetes or metabolic syndrome, they found again that women who had had gestational diabetes measured an average 0.023 mm thicker arteries, even after taking into account age, race, number of children and weight before pregnancy.

The researchers therefore concluded that having gestational diabetes may be a risk factor for developing later atherosclerosis, regardless of a woman's pre-pregnancy weight and even if she does not develop type 2 diabetes or metabolic syndrome.

Andre Hall, MD, an OBGYN at Birth and Women's Care, PA in Fayetteville, NC, explained that gestational diabetes is most often diagnosed at approximately 28 weeks of pregnancy following a blood glucose (sugar) test.

Being tested and monitoring the health of a woman with gestational diabetes is important for both the baby's health and the mother's health, he said, especially because of the increased risk for the mother of developing diabetes later in life.

"The take home message is to eat foods rich in sugars in moderation during pregnancy and, if diagnosed with gestational diabetes, to follow your doctor's nutritional instructions," Dr. Hall said. "Smart eating then needs to continue after the pregnancy."

This study was published March 12 in the Journal of the American Heart Association. The research was funded by the National Heart, Lung and Blood Institute and the Intramural Research Program of the National Institute on Aging.

The lead authors also received grants from the National Institute of Diabetes, Digestive and Kidney Diseases and from the Kaiser Permanent of Northern California Community Benefit Program in Oakland.

Review Date: 
March 11, 2014