A woman who develops gestational diabetes during pregnancy is at a higher risk for developing type 2 diabetes later in life. But what about women with other pregnancy complications?
A recent study found that two other complications, in a first pregnancy, were also linked to an increased risk for developing type 2 diabetes.
Those two complications were giving birth to a very preterm baby and giving birth to an oversized baby.
It is possible that women with a higher risk for type 2 diabetes could reduce their risk through lifestyle and behavior changes.
This study, led by Tamarra M. James-Todd, PhD, of the Division of Women's Health at Brigham and Women's Hospital in Boston, looked at the risk of developing type 2 diabetes among women with various complications during their first pregnancy.
The researchers looked specifically at giving birth early (preterm), giving birth late (post-term), having a baby with low birth weight or having an oversized baby (very large birth weight).
A very preterm birth was defined as being born from 20 to 32 weeks, and moderate preterm was defined as giving birth from 33 to 37 weeks.
A baby born at full term was defined as a birth from 38 to 42 weeks, and a post-term baby was born at 43 weeks or later.
A baby with a low birth weight was defined as one weighing less than 5.5 pounds, and an oversized baby was defined as weighing 10 pounds or more.
The researchers analyzed the data from 51,728 women, aged 25 to 42, in the Nurses' Health Study II who gave birth to a single baby.
The women were tracked from their first pregnancy (the first one was in 1964) through 2005.
Among the 2 percent of women who had a very preterm birth, the odds of developing type 2 diabetes later in life was approximately 1.3 times greater than for women who had a baby born at term.
The increased risk for these women did not appear until about a decade after their first pregnancy.
The 1.5 percent of women in the study who gave birth to an oversized baby also had 1.6 times greater odds of developing type 2 diabetes, even after adjustment for other risk factors for diabetes, including gestational diabetes.
For these women, the increased risk of developing type 2 diabetes showed up primarily within the first five years after their first pregnancy.
Women who gave birth moderately preterm or who had babies with a low birth weight did not have an increased risk of developing type 2 diabetes during the approximately 35 years of follow-up.
"Women who experienced a very preterm birth or had an infant that weighed 10 pounds or more may benefit from lifestyle intervention to reduce type 2 diabetes mellitus risk," the researchers wrote.
Various lifestyle changes that can reduce a person's risk of type 2 diabetes.
"Patients can alter and improve outcomes with healthy diet and exercise," said Jennifer Mushtaler, MD, an obstetrician in Austin, Texas.
"I recently delivered my patient's second baby. Her first pregnancy was complicated by excessive weight gain and type 2 diabetes," Dr. Mushtaler said. "This time, she heeded dietary instructions and weight gain recommendations and enjoyed a healthy pregnancy."
This study was published September 19 in the CDC's Preventing Chronic Disease. No conflicts of interest were reported.
The research was funded by Harvard Catalyst, The Harvard Clinical and Translational Science Center with the National Center for Research Resources and the National Center for Advancing Translational Sciences and a National Institutes of Health Award.