Women who deliver preterm or have hypertensive disorders of pregnancy face increased long-term risk of type 2 diabetes, as shown in a retrospective study.
The study included 2,184,417 women with a singleton delivery in Sweden. None of them had pre-existing diabetes mellitus. Follow-ups were conducted for the development of type 2 diabetes.
Cox regression was used to explore the association between preterm delivery or hypertensive disorders of pregnancy and the incidence of type 2 diabetes. Factors such as gestational diabetes status and other maternal factors were included as confounders.
Pregnancy complications were associated with an elevated risk of type 2 diabetes occurring within 10 years after delivery. The corresponding adjusted hazard ratios (HRs) were 1.96 (95 percent confidence interval [CI], 1.83–2.09) among women with any preterm delivery (before 37 weeks of gestation), 2.53 (95 percent CI, 2.03–3.16) among women with extremely preterm delivery (22–27 weeks), and 1.52 (95 percent CI, 1.43–1.63) among women with hypertensive disorders of pregnancy.
Notably, the risk of incident type 2 diabetes associated with the reported pregnancy complications remained significantly elevated (1.1–1.7-fold) 30–46 years after delivery.
Results of co-sibling analyses indicated that the associations were largely unexplained by shared familial factors.
The present data highlight that women with pregnancy complications are candidates for early preventive actions and long-term monitoring for type 2 diabetes.