Women diagnosed with gestational diabetes (GD) are almost 3 times as likely to develop ischaemic heart disease (IHD) as women without GD, UK figures suggest. The data also reveal that follow-up cardiovascular screening of women with GD is poor.
The retrospective cohort study, published in PLoS Medicine, found women with GD were more likely to be diagnosed with type 2 diabetes (incidence rate ratio [IRR], 21.96; P<.001), hypertension (IRR, 1.85; P<.001) and IHD (IRR, 2.78; P=.005), after adjusting for covariates including BMI and smoking, lipid-lowering medication and hypertension at baseline. Among the women with GD who developed IHD, only a third also developed type 2 diabetes in the postpartum period, suggesting the risk for cardiovascular disease is not always mediated by type 2 diabetes.
Less than 60% of women with GD had some form of glycaemic measurement in the first postpartum year. In the second and third year, this decreased to less than 40%. Almost a quarter of the women had no record of any glycaemic measurement in the first 3 years postpartum. Only half had their BP recorded in the second year after delivery. About a third had smoking status recorded, and very few had lipids recorded, in the third year postpartum.
This is the first large population-based study in the United Kingdom that reports on the increased risk for cardiovascular disease in women diagnosed with GD, and quantifies the high incidence of type 2 diabetes and hypertension for these women in the postpartum period.
