title: Early cardiovascular events in women with a history of gestational diabetes mellitus.
abstract: BACKGROUND
  The effect of gestational diabetes mellitus (GDM) on cardiovascular diseases (CVD) is not assessed within the first 10 years postpartum, regardless of subsequent diabetes. The aim of this study was to determine the risk of CVD events related to GDM within 7 years of postpartum.
  
  
  METHODS
  This nationwide population-based study of deliveries in 2007 and 2008 with a follow-up of 7 years was based on data from the French medico-administrative database. Two groups were formed: women with a history of GDM and women without GDM or previous diabetes. CVD included angina pectoris, myocardial infarction, stroke, heart bypass surgery, coronary angioplasty, carotid endarterectomy and fibrinolysis. Hypertensive disease was assessed separately. Determinants studied included age, obesity, subsequent diabetes mellitus and hypertensive diseases during pregnancy. Adjusted odds ratios for outcomes were calculated using multiple logistic regressions.
  
  
  RESULTS
  The hospital database recorded 1,518,990 deliveries in 2007 and 2008. Among these, 62,958 women had a history of GDM. After adjusting for age, DM, obesity and hypertensive disorders in pregnancy, GDM was significantly associated with a higher risk of CVD (adjusted Odds Ratio aOR = 1.25 [1.09-1.43]). Considering each variable in a separate model, GDM was associated with angina pectoris (aOR = 1.68 [1.29-2.20]), myocardial infarction (aOR = 1.92 [1.36-2.71]) and hypertension (aOR = 2.72 [2.58-2.88]) but not with stroke.
  
  
  CONCLUSIONS
  A history of GDM was identified as a risk factor of CVD, especially coronary vascular diseases, within the 7 years postpartum. A lifestyle changes from postpartum onwards can be recommended and supported.
authors.affiliation: CHRU Dijon, Service de Biostatistique et d'Informatique Médicale (DIM), Université de Bourgogne, 21000, Dijon, France. karine.goueslard@chu-dijon.fr.
authors.forename: Karine
authors.initials: K
authors.lastname: Goueslard
authors.affiliation: CHRU Dijon, Service de Biostatistique et d'Informatique Médicale (DIM), Université de Bourgogne, 21000, Dijon, France. jonathan.cottenet@chu-dijon.fr.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Cottenet
authors.affiliation: CHRU Dijon, Service de Biostatistique et d'Informatique Médicale (DIM), Université de Bourgogne, 21000, Dijon, France. anne-sophie.mariet@chu-dijon.fr.
authors.forename: Anne-Sophie
authors.initials: AS
authors.lastname: Mariet
authors.affiliation: Registre dijonnais des AVC, INSERM, INVS, EA4184, Univ. Bourgogne Franche-Comté, 21000, Dijon, France. maurice.giroud@chu-dijon.fr.
authors.forename: Maurice
authors.initials: M
authors.lastname: Giroud
authors.affiliation: Service de Cardiologie, CHRU Dijon, 21000, Dijon, France. yves.cottin@chu-dijon.fr.
authors.forename: Yves
authors.initials: Y
authors.lastname: Cottin
authors.affiliation: Centre de Recherche INSERM Unité 866, Univ. Bourgogne Franche-Comté, 21000, Dijon, France. jean-michel.petit@chu-dijon.fr.|Services de diabétologie et endocrinologie, CHRU Dijon, 21000, Dijon, France. jean-michel.petit@chu-dijon.fr.|Centre Hospitalier Universitaire, BP 77908, 21079, Dijon Cedex, France. jean-michel.petit@chu-dijon.fr.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Petit
authors.affiliation: CHRU Dijon, Service de Biostatistique et d'Informatique Médicale (DIM), Université de Bourgogne, 21000, Dijon, France. catherine.quantin@chu-dijon.fr.|Clinical Investigation Center, clinical epidemiology/clinical trials unit, INSERM CIC 1432, Dijon University Hospital, 21000, Dijon, France. catherine.quantin@chu-dijon.fr.|INSERM, UMR1181, Biostatistics, Biomathematics, Pharmacoepidemiology and Infectious Diseases (B2PHI), Univ. Bourgogne Franche-Comté, 21000, Dijon, France. catherine.quantin@chu-dijon.fr.
authors.forename: Catherine
authors.initials: C
authors.lastname: Quantin
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology*; D016022:Case-Control Studies; D015897:Comorbidity; D016208:Databases, Factual; D016640:Diabetes, Gestational / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D016017:Odds Ratio; D011247:Pregnancy; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult
references.citation: J Am Heart Assoc. 2014;3(2):e000490
references.pmid: 24622610
references.citation: Acta Diabetol. 2015 Feb;52(1):153-60
references.pmid: 25002067
references.citation: Heart Views. 2015 Jan-Mar;16(1):13-8
references.pmid: 25838873
references.citation: BJOG. 2014 Nov;121(12):1530-6
references.pmid: 24762194
references.citation: Curr Diab Rep. 2012 Feb;12(1):43-52
references.pmid: 22037824
references.citation: J Clin Endocrinol Metab. 2005 Jul;90(7):3983-8
references.pmid: 15840749
references.citation: Rev Epidemiol Sante Publique. 2015 Aug;63(4):237-46
references.pmid: 26143088
references.citation: Lancet. 2009 May 23;373(9677):1773-9
references.pmid: 19465232
references.citation: Lancet. 2001 Jun 23;357(9273):2002-6
references.pmid: 11438131
references.citation: Cardiovasc Diabetol. 2014;13:104
references.pmid: 24981579
references.citation: Stroke. 2015 Jan;46(1):190-6
references.pmid: 25378425
references.citation: Diabetes Care. 2007 Jul;30 Suppl 2:S251-60
references.pmid: 17596481
references.citation: J Public Health (Oxf). 2013 Mar;35(1):147-56
references.pmid: 22829662
references.citation: Open Med. 2014;8(1):e1-9
references.pmid: 25009679
references.citation: J Womens Health (Larchmt). 2011 Feb;20(2):287-93
references.pmid: 21265636
references.citation: Gend Med. 2006 Jun;3(2):131-58
references.pmid: 16860272
references.citation: Cardiovasc Diabetol. 2014;13:138
references.pmid: 25281032
references.citation: CMAJ. 2009 Sep 15;181(6-7):371-6
references.pmid: 19703913
references.citation: BMC Cardiovasc Disord. 2014;14:132
references.pmid: 25266849
references.citation: Womens Health (Lond Engl). 2014 Jan;10(1):91-108
references.pmid: 24328601
references.citation: Am J Cardiol. 2014 Apr 15;113(8):1364-70
references.pmid: 24576544
references.citation: Circulation. 2013 Feb 12;127(6):681-90
references.pmid: 23401113
references.citation: Diabetes Care. 2006 Sep;29(9):2078-83
references.pmid: 16936156
references.citation: Diabetes Care. 2002 Oct;25(10):1862-8
references.pmid: 12351492
references.citation: Nat Clin Pract Nephrol. 2007 Nov;3(11):613-22
references.pmid: 17957198
references.citation: Circulation. 2013 Apr 30;127(17):1767-74
references.pmid: 23543004
references.citation: Hypertension. 2012 Dec;60(6):1368-73
references.pmid: 23071130
references.citation: Curr Opin Cardiol. 2014 Sep;29(5):447-53
references.pmid: 25003394
references.citation: Diabetes Care. 2013 Jan;36 Suppl 1:S67-74
references.pmid: 23264425
references.citation: Eur Respir J. 2015 Aug;46(2):503-11
references.pmid: 26022949
references.citation: Diabetes Care. 1998 Dec;21(12):2111-5
references.pmid: 9839102
references.citation: Diabetes Care. 2008 Aug;31(8):1668-9
references.pmid: 18487472
references.citation: Nat Clin Pract Cardiovasc Med. 2006 Nov;3(11):596-603
references.pmid: 17063164
references.citation: J Gynecol Obstet Biol Reprod (Paris). 2014 Nov;43(9):680-90
references.pmid: 24135017