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Diabetes risk in women with gestational diabetes mellitus and a history of polycystic ovary syndrome: a retrospective cohort study.

Abstract

AIMS

To investigate whether polycystic ovary syndrome further increases postpartum diabetes risk in women with gestational diabetes mellitus and to explore relationships between polycystic ovary syndrome and incident diabetes in women who do not develop gestational diabetes.

METHODS

This retrospective cohort study (Quebec Physician Services Claims; Hospitalization Discharge Databases; Birth and Death registries) included 34 686 women with gestational diabetes during pregnancy (live birth), matched 1:1 to women without gestational diabetes by age group, year of delivery and health region. Diagnostic codes were used to define polycystic ovary syndrome and incident diabetes. Cox regression models were used to examine associations between polycystic ovary syndrome and incident diabetes.

RESULTS

Polycystic ovary syndrome was present in 1.5% of women with gestational diabetes and 1.2% of women without gestational diabetes. There were more younger mothers and mothers who were not of white European ancestry among those with polycystic ovary syndrome. Those with polycystic ovary syndrome more often had a comorbidity and a lower proportion had a previous pregnancy. Polycystic ovary syndrome was associated with incident diabetes (hazard ratio 1.52; 95% CI 1.27, 1.82) among women with gestational diabetes. No conclusive associations between polycystic ovary syndrome and diabetes were identified (hazard ratio 0.94; 95% CI 0.39, 2.27) in women without gestational diabetes.

CONCLUSION

In women with gestational diabetes, polycystic ovary syndrome confers additional risk for incident diabetes postpartum. In women without gestational diabetes, an association between PCOS and incident diabetes was not observed. Given the already elevated risk of diabetes in women with a history of gestational diabetes, a history of both polycystic ovary syndrome and gestational diabetes signal a critical need for diabetes surveillance and prevention.

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  • Authors+Show Affiliations

    ,

    Department of Medicine, Division of Endocrinology and Metabolism, McGill University, Montreal, Quebec, Canada.

    ,

    Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada.

    ,

    Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada. Department of Medicine, McGill University, Montreal, Quebec, Canada.

    Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada. Department of Medicine, McGill University, Montreal, Quebec, Canada.

    Source

    MeSH

    Adult
    Diabetes Mellitus, Type 2
    Diabetes, Gestational
    Female
    Humans
    Incidence
    Infant, Newborn
    Polycystic Ovary Syndrome
    Pregnancy
    Pregnancy Complications
    Pregnancy Outcome
    Quebec
    Reproductive History
    Retrospective Studies
    Risk Factors
    Young Adult

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    28782842

    Citation

    Bond, R, et al. "Diabetes Risk in Women With Gestational Diabetes Mellitus and a History of Polycystic Ovary Syndrome: a Retrospective Cohort Study." Diabetic Medicine : a Journal of the British Diabetic Association, vol. 34, no. 12, 2017, pp. 1684-1695.
    Bond R, Pace R, Rahme E, et al. Diabetes risk in women with gestational diabetes mellitus and a history of polycystic ovary syndrome: a retrospective cohort study. Diabet Med. 2017;34(12):1684-1695.
    Bond, R., Pace, R., Rahme, E., & Dasgupta, K. (2017). Diabetes risk in women with gestational diabetes mellitus and a history of polycystic ovary syndrome: a retrospective cohort study. Diabetic Medicine : a Journal of the British Diabetic Association, 34(12), pp. 1684-1695. doi:10.1111/dme.13444.
    Bond R, et al. Diabetes Risk in Women With Gestational Diabetes Mellitus and a History of Polycystic Ovary Syndrome: a Retrospective Cohort Study. Diabet Med. 2017;34(12):1684-1695. PubMed PMID: 28782842.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Diabetes risk in women with gestational diabetes mellitus and a history of polycystic ovary syndrome: a retrospective cohort study. AU - Bond,R, AU - Pace,R, AU - Rahme,E, AU - Dasgupta,K, Y1 - 2017/09/01/ PY - 2017/08/02/accepted PY - 2017/8/8/pubmed PY - 2018/7/28/medline PY - 2017/8/8/entrez SP - 1684 EP - 1695 JF - Diabetic medicine : a journal of the British Diabetic Association JO - Diabet. Med. VL - 34 IS - 12 N2 - AIMS: To investigate whether polycystic ovary syndrome further increases postpartum diabetes risk in women with gestational diabetes mellitus and to explore relationships between polycystic ovary syndrome and incident diabetes in women who do not develop gestational diabetes. METHODS: This retrospective cohort study (Quebec Physician Services Claims; Hospitalization Discharge Databases; Birth and Death registries) included 34 686 women with gestational diabetes during pregnancy (live birth), matched 1:1 to women without gestational diabetes by age group, year of delivery and health region. Diagnostic codes were used to define polycystic ovary syndrome and incident diabetes. Cox regression models were used to examine associations between polycystic ovary syndrome and incident diabetes. RESULTS: Polycystic ovary syndrome was present in 1.5% of women with gestational diabetes and 1.2% of women without gestational diabetes. There were more younger mothers and mothers who were not of white European ancestry among those with polycystic ovary syndrome. Those with polycystic ovary syndrome more often had a comorbidity and a lower proportion had a previous pregnancy. Polycystic ovary syndrome was associated with incident diabetes (hazard ratio 1.52; 95% CI 1.27, 1.82) among women with gestational diabetes. No conclusive associations between polycystic ovary syndrome and diabetes were identified (hazard ratio 0.94; 95% CI 0.39, 2.27) in women without gestational diabetes. CONCLUSION: In women with gestational diabetes, polycystic ovary syndrome confers additional risk for incident diabetes postpartum. In women without gestational diabetes, an association between PCOS and incident diabetes was not observed. Given the already elevated risk of diabetes in women with a history of gestational diabetes, a history of both polycystic ovary syndrome and gestational diabetes signal a critical need for diabetes surveillance and prevention. SN - 1464-5491 UR - https://www.unboundmedicine.com/medline/citation/28782842/Diabetes_risk_in_women_with_gestational_diabetes_mellitus_and_a_history_of_polycystic_ovary_syndrome:_a_retrospective_cohort_study_ L2 - https://doi.org/10.1111/dme.13444 DB - PRIME DP - Unbound Medicine ER -