A cohort study of reproductive risk factors, weight and weight change and the development of diabetes mellitus

Diabetes Obes Metab. 2003 Jul;5(4):244-50. doi: 10.1046/j.1463-1326.2003.00269.x.

Abstract

Aims: Reproductive factors (parity, miscarriages, terminations), oral contraceptive use, hormone replacement therapy, body weight at first pregnancy and weight gain following pregnancy may be associated with a long-term risk of diabetes. The aim of this study is to investigate the independent risks of reproductive factors and body weight for diabetes in later life.

Methods: This is a retrospective cohort study of 1257 parous women who had a first pregnancy between 1951 and 1970. Reproductive history, weight and height were measured at the time of first pregnancy, then assessed by questionnaire in 1997 for all women. A clinical examination and an analysis of blood samples were undertaken for 992 women. The main outcome was incidence of diabetes based on medical history, medication and random glucose measurement.

Results: Sixty of the 1257 (4.8%) women developed diabetes. Body mass index at index pregnancy and after 28-48 years follow-up were both significantly associated with risk of diabetes, this increased with greater weight gain. There was a non-significant increased risk of diabetes associated with stillbirths and miscarriages after age and BMI adjustment.

Conclusions: In parous women, higher BMI at index pregnancy, weight gain during follow-up and BMI in later life strongly predict diabetes risk.

MeSH terms

  • Abortion, Induced
  • Abortion, Spontaneous
  • Adult
  • Body Mass Index
  • Cohort Studies
  • Contraceptives, Oral / adverse effects
  • Diabetes Mellitus / etiology*
  • Female
  • Hormone Replacement Therapy / adverse effects
  • Humans
  • Maternal Age
  • Middle Aged
  • Parity
  • Pregnancy / physiology*
  • Retrospective Studies
  • Risk Factors
  • Weight Gain / physiology*

Substances

  • Contraceptives, Oral