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Diabetes and endocrinology
Research
Metabolic syndrome in Finnish women 7 years after a gestational diabetes prevention trial
  1. Jatta Puhkala1,
  2. Jani Raitanen1,2,
  3. Päivi Kolu1,
  4. Pipsa Tuominen1,
  5. Pauliina Husu1,
  6. Riitta Luoto1,2
  1. 1UKK Institute for Health Promotion Research, Tampere, Finland
  2. 2School of Health Sciences, University of Tampere, Tampere, Finland
  1. Correspondence to Jatta Puhkala; jatta.puhkala{at}uta.fi

Abstract

Background Risk for developing metabolic syndrome (MeS) after delivery is high among women with gestational diabetes mellitus (GDM), but little is known about development of MeS among women with risk factors for GDM during pregnancy. In the present study, we studied the prevalence of MeS 7 years postpartum among women with GDM risk factors during pregnancy, women with early GDM diagnosis and women without GDM risk factors. We also analysed the early pregnancy risk factors associated with MeS.

Methods A Finnish cluster randomised controlled GDM prevention trial was conducted in 2007–2009. The prevalence of MeS according to International Diabetes Federation criteria was determined in the follow-up study 7 years after original trial. Eligible participants (n=289) in 4 study groups (intervention (n=83) and usual care (n=87) with GDM risk factors; early GDM (n=51), and healthy control without GDM risk factors (n=68)) were evaluated for MeS. Binary logistic regression models were used to analyse risk factors associated with MeS.

Results 7 years postpartum, the MeS prevalence was 14% (95% CI 8% to 25%) in the intervention group; 15% (CI 8% to 25%) in the usual care group; 50% (CI 35% to 65%) in the early GDM group and 7% (CI 2% to 18%) in the healthy control group. OR for MeS in women with GDM risk factors did not differ from the healthy control group. Body mass index (BMI)-adjusted OR for MeS was 9.18 (CI 1.82 to 46.20) in the early GDM group compared with the healthy control group. Increased prepregnancy BMI was associated with MeS (OR, 1.17, CI 1.08 to 1.28, adjusted for group).

Conclusions Increased prepregnancy BMI and early GDM diagnosis were the strongest risk factors for developing MeS 7 years postpartum. Overweight and obese women and especially those with early GDM should be monitored and counselled for cardiometabolic risk factors after delivery.

  • Metabolic syndrome
  • gestational diabetes
  • postpartum
  • follow-up
  • pregnancy
  • women

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2016-014565

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    Footnotes

    • Contributors RL, JP, PK, PT and PH initiated the study design; JR and JP performed statistical analyses; JP wrote the paper. All authors contributed to refinement of the study protocol and approved the final manuscript. JP and RL have the primary responsibility for the final content.

    • Funding This work was supported by Academy Finland (grant number 277079), Competitive Research Funding of the Tampere University Hospital (9R030, 9S034, 9N041, 9M053) and the Juho Vainio Foundation.

    • Competing interests None declared.

    • Ethics approval Pirkanmaa University Hospital District Ethics.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement All data presented in this study are available for further collaboration after request to RL (riitta.luoto@uta.fi).