title: The association between a history of gestational diabetes mellitus and future risk for female malignancies.
abstract: OBJECTIVE
  To investigate whether patients with a history of gestational diabetes mellitus (GDM) have an increased future risk for female malignancies.
  
  
  METHODS
  A population-based study compared the incidence of long-term female malignancies (ovary, uterine, breast, and uterine cervix) in a cohort of women with and without a diagnosis of GDM. Deliveries occurred between the years 1988-2013, with a mean follow-up duration of 12 years. Women with known malignancies prior to the index pregnancy were excluded. Kaplan-Meier survival curve was used to estimate cumulative incidence of malignancies. Cox proportional hazards models were used to estimate the adjusted hazard ratios (HR) for female malignancy.
  
  
  RESULTS
  During the study period, 1,04,715 deliveries met the inclusion criteria; 9.4% (n = 9893) occurred in patients with a history of GDM in at least one of their pregnancies. During the follow-up period, patients with GDM had a significantly increased risk of being diagnosed with female malignancies, including ovarian, uterine, and breast cancer. Using a Kaplan-Meier survival curve, patients with a previous diagnosis of GDM had a significantly higher cumulative incidence of female malignancies. Using a Cox proportional hazards model, adjusted for confounders, such as parity, maternal age, and fertility treatments, a history of GDM remained independently associated with female malignancies (adjusted HR, 1.3; 95% CI 1.2-1.6; P = 0.001).
  
  
  CONCLUSIONS
  Patients with a history of GDM have an increased risk for future breast, ovarian, and uterine malignancies.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, POB 151, 84101, Beer Sheva, Israel.
authors.forename: Oded
authors.initials: O
authors.lastname: Fuchs
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, POB 151, 84101, Beer Sheva, Israel. sheiner@bgu.ac.il.
authors.forename: Eyal
authors.initials: E
authors.lastname: Sheiner
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, POB 151, 84101, Beer Sheva, Israel.
authors.forename: Mihai
authors.initials: M
authors.lastname: Meirovitz
authors.affiliation: Soroka University Medical Center, Clalit Health Services (Southern District), Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Ehud
authors.initials: E
authors.lastname: Davidson
authors.affiliation: Department of Public Health, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Ruslan
authors.initials: R
authors.lastname: Sergienko
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, POB 151, 84101, Beer Sheva, Israel.
authors.forename: Roy
authors.initials: R
authors.lastname: Kessous
mesh_terms: D000328:Adult; D016640:Diabetes, Gestational; D005260:Female; D005833:Genital Neoplasms, Female / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D015994:Incidence; D011247:Pregnancy; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Breast cancer; Gestational diabetes mellitus; Long-term risk; Ovarian cancer; Uterine cancer