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Cardiovascular risk factors in women with previous gestational diabetes mellitus: A systematic review and meta-analysis

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Abstract

This systematic review and meta-analysis aimed to synthesize evidence on conventional cardiovascular disease (CVD) risk factors among women with previous Gestational Diabetes Mellitus (GDM). The review protocol is registered with PROSPERO (CRD42019118149). PubMed, CINAHL, SCOPUS, and EMBASE databases were searched. Studies reporting on CVD risk factors in women with previous GDM compared to women without previous GDM were selected. A total of 139 studies were eligible, of which 93 were included in the meta-analysis. Women with previous GDM have significantly higher systolic blood pressure (2.47 mmHg 95% CI 1.74 to 3.40, n = 48, 50,118 participants) diastolic blood pressure (1.89 mmHg 95% CI 1.32 to 2.46, n = 48, 49,495 participants), BMI (1.54 kg/m2 95% CI 1.32 to 2.46, n = 78, 255,308 participants), total cholesterol (0.26 SMD 95% CI 0.15 to 0.37, n = 48, 38,561 participants), LDL cholesterol (0.19 SMD 95% CI 0.08 to 0.30, n = 44, 16,980 participants), triglycerides (0.56 SMD 95% CI 0.42 to 0.70, n = 46, 13,175 participants), glucose (0.69 SMD 95% CI 0.56 to 0.81, n = 55, 127,900 participants), insulin (0.41 SMD 95% CI 0.23 to 0.59, n = 32, 8881 participants) and significantly lower HDL cholesterol (−0.28 SMD 95% CI −0.39 to −0.16, n = 56, 35,882 participants), compared to women without previous GDM. The increased blood pressure, total cholesterol, triglycerides and glucose are seen as early as <1 year post-partum.Women with previous GDM have a higher risk of CVD based on significant increases in conventional risk factors. Some risk factors are seen as early as <1 year post-partum. Women with GDM may benefit from early screening to identify modifiable CVD risk factors.

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Abbreviations

CVD:

cardiovascular disease

GDM:

gestational diabetes mellitus

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Funding

ZSL is supported by a NHMRC Australia Public Health Early Career Fellowship (GNT1141382). MMP is supported by a Divisional Scholarship by The Faculty of Health Sciences, University of Adelaide.

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Authors and Affiliations

  1. Adelaide Medical School and The Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia

    Maleesa M. Pathirana, Zohra Lassi, Claire T. Roberts & Prabha H. Andraweera

  2. Faculty of Health and Medical Sciences, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia

    Maleesa M. Pathirana, Zohra Lassi, Anna Ali, Margaret Arstall, Claire T. Roberts & Prabha H. Andraweera

  3. Basil Hetzel Institute, The Queen Elizabeth Hospital, Woodville, SA, Australia

    Anna Ali

  4. Adelaide G-TRAC Centre & CRE Frailty & Healthy Ageing Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia

    Anna Ali

  5. Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, SA, Australia

    Margaret Arstall & Prabha H. Andraweera

  6. Flinders Health and Medical Research Institute, Flinders University, Bedford Park, SA, Australia

    Claire T. Roberts

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Pathirana, M.M., Lassi, Z., Ali, A. et al. Cardiovascular risk factors in women with previous gestational diabetes mellitus: A systematic review and meta-analysis. Rev Endocr Metab Disord 22, 729–761 (2021). https://doi.org/10.1007/s11154-020-09587-0

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  • DOI: https://doi.org/10.1007/s11154-020-09587-0

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