Women Who Develop Diabetes Later in Life Have Diabetes-Associated Complications during Preceding Pregnancies

Abstract

Aims: The aim of this study was to explore the outcome of previous pregnancies in women who later developed diabetes. Method: A Swedish population based cohort of 23,524 women from 1990 aged 45 - 85 yr in 2000 when they self reported health status in a questionnaire. To identify which women who delivered we matched it towards the Swedish Medical Birth Register (SMBR). We identified 14,856 women who appeared in both registers and a total of 30,559 new birth registrations. Among these women 216 had developed diabetes after their pregnancy (ies) and additional twelve women were reported to have gestational diabetes in SMBR. These 228 women and their 455 pregnancies were compared with women without diabetes. Results: Women who developed diabetes later in life were already heavier before the pregnancy (ies) (69.2 ± 13.9 vs. 63.2 ± 10.3 kg; p < 0.001) but had less weight gain during pregnancy (13.3 ± 5.4 vs. 14.1 ± 4.6 kg; p = 0.03) compared to women without diabetes. Newborns to women with diabetes diagnosed any time after pregnancy had higher birth weight (3602 vs. 3507 g; p < 0.001), were more often large for gestational age (10.5% vs. 3.1%; p < 0.001), were more often delivered by caesarean section (4.8% vs. 2.7%; p = 0.005) and had lower Apgar scores. Conclusion: Women who developed diabetes after pregnancy had hyperglycaemia-associated complications during their pregnancy (ies). We therefore postulated that women with Type 2 diabetes are mainly recruited from women with earlier GDM. A general screening for GDM should identify these women and enable life style intervention that may prevent or at least delay diabetes.