BackgroundGestational diabetes mellitus increases the risk of developing type 2 diabetes. The aim of this study is to compare cardiometabolic and renal outcomes for all women in New Zealand with gestational diabetes (2001–2010) with women without diabetes, 10–20 years following delivery.MethodsA retrospective cohort study, utilizing a national dataset providing information for all women who gave birth between 1 January 2001 and 31 December 2010 (n = 604 398). Adolescent girls <15 years, women ≥50 years and women with prepregnancy diabetes were excluded. In total 11 459 women were diagnosed with gestational diabetes and 11 447 were matched (for age and year of delivery) with 57 235 unexposed (control) women. A national hospital dataset was used to compare primary outcomes until 31 May 2021.ResultsAfter controlling for ethnicity, women with gestational diabetes were significantly more likely than control women to develop diabetes—adjusted hazard ratio (HR) 20.06 and 95% confidence interval (CI) 18.46–21.79; a first cardiovascular event 2.19 (1.86–2.58); renal disease 6.34 (5.35–7.51) and all‐cause mortality 1.55 (1.31–1.83), all p values <.0001. The HR and 95% CI remained similar after controlling for significant covariates: diabetes 18.89 (17.36–20.56), cardiovascular events 1.79 (1.52–2.12), renal disease 5.42 (4.55–6.45), and all‐cause mortality 1.44 (1.21–1.70). When time‐dependent diabetes was added to the model, significance remained for cardiovascular events 1.33 (1.10–1.61), p = .003 and renal disease 2.33 (1.88–2.88), p < .0001 but not all‐cause mortality.ConclusionsWomen diagnosed with gestational diabetes have an increased risk of adverse cardiometabolic and renal outcomes. Findings highlight the importance of follow‐up screening for diabetes, cardiovascular risk factors, and renal disease.image

中文翻译：

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新西兰所有被诊断患有妊娠期糖尿病的女性患心血管疾病、肾脏疾病和糖尿病的风险增加——一项全国回顾性队列研究

背景妊娠糖尿病会增加患 2 型糖尿病的风险。本研究的目的是比较新西兰所有患有妊娠糖尿病的女性（2001-2010 年）与未患糖尿病的女性在分娩后 10-20 年的心脏代谢和肾脏结果。方法一项回顾性队列研究，利用提供信息的国家数据集2001年1月1日至2010年12月31日期间生育的所有妇女（n= 604 398）。排除<15岁的青春期女孩、≥50岁的女性和患有孕前糖尿病的女性。总共有 11 459 名女性被诊断患有妊娠期糖尿病，其中 11 44​​7 名女性（按年龄和分娩年份）与 57 235 名未暴露的（对照）女性进行了匹配。使用全国医院数据集来比较截至 2021 年 5 月 31 日的主要结局。结果在控制种族后，患有妊娠糖尿病的女性比对照组女性显着更容易患糖尿病——调整后的风险比 (HR) 20.06 和 95% 置信区间 (CI) 18.46–21.79；首次心血管事件 2.19 (1.86–2.58)；肾脏疾病 6.34 (5.35–7.51) 和全因死亡率 1.55 (1.31–1.83)，全部p值<.0001。控制显着协变量后，HR 和 95% CI 保持相似：糖尿病 18.89 (17.36–20.56)、心血管事件 1.79 (1.52–2.12)、肾脏疾病 5.42 (4.55–6.45) 和全因死亡率 1.44 (1.21–1.70) ）。当将时间依赖性糖尿病添加到模型中时，心血管事件仍然具有显着性 1.33 (1.10–1.61)，p= .003 和肾脏疾病 2.33 (1.88–2.88)，p< 0.0001，但不是全因死亡率。结论被诊断患有妊娠糖尿病的女性出现不良心脏代谢和肾脏结果的风险增加。研究结果强调了对糖尿病、心血管危险因素和肾脏疾病进行随访筛查的重要性。图像