title: Gestational diabetes mellitus is a significant risk factor for long-term maternal renal disease.
abstract: BACKGROUND
  Gestational diabetes mellitus (GDM) was found to be an independent risk factor for recurrent long-term type 2 diabetes mellitus, cardiovascular morbidity, and vascular endothelial dysfunction. However, data on the link between GDM and future risk for long-term maternal renal disease are limited.
  
  
  OBJECTIVE
  The purpose of this study was to investigate whether GDM poses a risk for subsequent long-term maternal renal morbidity.
  
  
  METHODS
  A population-based noninterventional study compared the incidence of future renal morbidity in a cohort of women with and without previous GDM. Deliveries occurred during a 25-year period, with a mean follow-up duration of 11.2 years.
  
  
  METHODS
  The study was conducted at the Soroka University Medical Center.
  
  
  METHODS
  The study population was composed of all singleton pregnancies in women who delivered between January 1988 and December 2013.
  
  
  METHODS
  The main outcome was diagnosis of renal morbidities.
  
  
  RESULTS
  Of 97,968 women who met the inclusion criteria, 9542 (9.7%) had at least 1 previous pregnancy with GDM. Using a Kaplan-Meier survival curve, we show that women with GDM had higher rates of total renal morbidity (0.1% vs 0.2%, for no GDM and with GDM, respectively; odds ratio, 2.3, 95% confidence interval, 1.4-3.7; P < .001). In addition, we found a significant dose-response association (using the χ(2) test for trends) between the number of pregnancies with GDM and future risk for renal morbidity (0.1%, 0.2%, and 0.4% for no GDM, 1 episode of GDM, and 2 episodes of GDM, respectively; P < .001). In a Cox proportional hazards model, adjusted for confounders, GDM was independently associated with future renal morbidity.
  
  
  CONCLUSIONS
  GDM is a significant risk factor for future maternal renal morbidity. The risk is more substantial for patients with recurrent episodes of GDM.
authors: Department of Obstetrics and Gynecology (O.B., G.P., R.K., Y.B., E.S.), Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer Sheva, 84101, Israel; Epidemiology and Health Services Evaluation (I.S.-V., R.S.), Ben-Gurion University of the Negev, Beer Sheva, 84101, Israel; and Department of Physiology and Cell Biology (I.S.-S.), Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, 84101, Israel.
authors: Ofer
authors: O
authors: Beharier
authors: Ilana
authors: I
authors: Shoham-Vardi
authors: Gali
authors: G
authors: Pariente
authors: Ruslan
authors: R
authors: Sergienko
authors: Roy
authors: R
authors: Kessous
authors: Yael
authors: Y
authors: Baumfeld
authors: Irit
authors: I
authors: Szaingurten-Solodkin
authors: Eyal
authors: E
authors: Sheiner
mesh_terms: D000328:Adult; D016640:Diabetes, Gestational / Q000453:epidemiology* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007674:Kidney Diseases / Q000453:epidemiology* / Q000628:therapy; D009017:Morbidity; D011247:Pregnancy; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult