CMAJ • September 15, 2009; 181 (6-7). First published August 24, 2009; doi:10.1503/cmaj.090569
© 2009 Canadian Medical Association or its licensors
All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association.
This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Résumé
Right arrow All Versions of this Article:
cmaj.090569v1
181/6-7/371    most recent
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Google Scholar
Right arrow Articles by Retnakaran, R.
Right arrow Articles by Shah, B. R.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Retnakaran, R.
Right arrow Articles by Shah, B. R.
Related Collections
Right arrow Other cardiovascular medicine
Right arrow Other endocrinology
Right arrow Pregnancy
Right arrowRelated Articles

Research

Mild glucose intolerance in pregnancy and risk of cardiovascular disease: a population-based cohort study

Ravi Retnakaran, MD and Baiju R. Shah, MD PhD

From the Leadership Sinai Centre for Diabetes, Mount Sinai Hospital (Retnakaran); the Department of Medicine, University of Toronto (Retnakaran, Shah); the Institute for Clinical Evaluative Sciences (Shah); and the Department of Medicine, Sunnybrook Health Sciences Centre (Shah), Toronto, Ont.

Correspondence to: Dr. Baiju R. Shah , 2075 Bayview Ave., Toronto ON M4N 3M5; fax: 416 480-6048; baiju.shah{at}ices.on.ca

Background: Pregnant women commonly receive screening for gestational diabetes mellitus by use of a 50 g glucose challenge test, followed by a diagnostic oral glucose tolerance test for those whose glucose challenge test result is abnormal. Although women with gestational diabetes have an increased risk of cardiovascular disease, it is not known whether mild glucose intolerance during pregnancy is also associated with cardiovascular disease. Thus, we sought to determine whether pregnant women with an abnormal glucose challenge test result but without gestational diabetes have an increased risk of cardiovascular disease.

Methods: We conducted a retrospective population-based cohort study that included all women in Ontario aged 20–49 years with live deliveries between April 1994 and March 1998. We excluded women with pregestational diabetes. The population was stratified into 3 cohorts: women with gestational diabetes (n = 13 888); women who received an antepartum oral glucose tolerance test (suggestive of an abnormal result of the glucose challenge test) but who did not have gestational diabetes (n = 71 831); and women who did not receive an oral glucose tolerance test (suggestive of a normal result of the glucose challenge test) (n = 349 977). The primary outcome was cardiovascular disease (admission to hospital for acute myocardial infarction, coronary bypass, coronary angioplasty, stroke or carotid endarterectomy).

Results: Compared with women who did not receive an oral glucose tolerance test, women with gestational diabetes and women who received an oral glucose tolerance test but did not have gestational diabetes had a higher risk of cardiovascular disease over 12.3 years of median follow-up (adjusted hazard ratio [HR] for women with gestational diabetes 1.66, 95% confidence interval [CI] 1.30–2.13, p < 0.001; adjusted HR for those with an oral glucose test but not gestational diabetes 1.19, 95% CI 1.02–1.39, p = 0.03).

Interpretation: Mild glucose intolerance in pregnancy may be associated with an increased risk of cardiovascular disease.


Related Articles

Highlights
Can. Med. Assoc. J. 2009 181: 353. [Full Text] [PDF]

Dans ce numéro
Can. Med. Assoc. J. 2009 181: E101. [Full Text] [PDF]

Pregnancy glycemia to vascular risk: Nonglycemic diabetes?
J. Kennedy Cruickshank and Moulinath Banerjee
Can. Med. Assoc. J. 2009 181: 361-362. [Full Text] [PDF]