Glucose intolerance in pregnancy associated with postpartum cardiovascular risk

Researchers in this study sought to evaluate the relationship between gestational glucose intolerance and postpartum risk of metabolic syndrome (defined as the clustering of several cardiometabolic risk factors including obesity, hypertension and low HDL cholesterol). Metabolic syndrome, like gestational diabetes itself, is associated with increased risk of developing type 2 diabetes and cardiovascular disease.

Researchers followed 487 women who underwent oral glucose tolerance testing during pregnancy. Each subject was classified as either having normal glucose tolerance, gestational glucose intolerance or gestational diabetes. At three months postpartum, researchers evaluated each subject's cardiometabolic characteristics, such as blood pressure, weight, waist measurement and lipid levels.

Findings support that even mild glucose intolerance during pregnancy predicts an increased likelihood of the metabolic syndrome at 3 months postpartum. The presence of cardiovascular risk factors as early as three months postpartum indicates that these risk factors may be longstanding and contribute to the long-term risk of cardiovascular disease in this patient population.

“The study findings raise the important possibility that women with gestational glucose intolerance and subsequent postpartum metabolic syndrome represent a patient population at particularly high risk for the future development of metabolic and vascular disease,” said Ravi Retnakaran, MD, of Mount Sinai Hospital and the University of Toronto and lead author of the study. “Further research with long-term follow-up is needed to address this possibility.”

“Our data also suggests that glucose tolerance screening in pregnancy, as is currently practiced, may provide previously unrecognized insight into a woman's postpartum cardiovascular risk-factor profile,” said Retnakaran. “Furthermore, glucose tolerance screening may identify subgroups of young women for whom cardiovascular risk-factor monitoring may be warranted.”

Other researchers working on the study include Ying Qi, Bernard Zinman and Mathew Sermer of Mount Sinai Hospital in Toronto, Canada; and Anthony Hanley and Philip Connelly of the University of Toronto in Canada.

The article, “Glucose Intolerance in Pregnancy and Postpartum Risk of Metabolic Syndrome in Young Women,” will appear in the February 2010 issue of JCEM.

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