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Infertility, Gravidity, and Risk Of Diabetes among High-Risk Women in the Diabetes Prevention Program Outcomes Study
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Infertility, Gravidity, and Risk Of Diabetes among High-Risk Women in the Diabetes Prevention Program Outcomes Study
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Journal Article
Infertility, Gravidity, and Risk Of Diabetes among High-Risk Women in the Diabetes Prevention Program Outcomes Study
2020
Overview
Abstract
Objective
The extent to which infertility and pregnancy independently increase risk of diabetes and subclinical atherosclerosis is not known.
Research Design And Methods
We conducted a secondary analysis of Diabetes Prevention Program (DPP) and the DPP Outcomes Study over a 15-year period. We included women who answered questions about gravidity and infertility at baseline (n = 2085). Infertility was defined as > 1 year of unsuccessful attempts to conceive; thus, women could have histories of infertility as well as pregnancy. Risk of diabetes associated with gravidity and infertility was calculated using Cox proportional hazards models adjusting for age, race/ethnicity, treatment arm, body mass index, and pregnancy during the study. Among women who underwent assessment of coronary artery calcification (CAC) (n = 1337), odds of CAC were calculated using logistic regression models with similar covariates.
Results
Among premenopausal women (n = 1075), women with histories of pregnancy and infertility (n = 147; hazard ratio [HR] 1.80; 95% confidence interval [CI] 1.30, 2.49) and women with histories of pregnancy without infertility (n = 736; HR 1.49; 95% CI 1.15, 1.93) had greater diabetes risk than nulligravid women without infertility (n = 173). Premenopausal nulligravid women with histories of infertility had a non-significant elevation in risk, although the number of these women was small (n = 19; HR 1.63; 95% CI 0.88, 3.03). Associations were not observed among postmenopausal women (n = 1010). No associations were observed between infertility or pregnancy with CAC.
Conclusions
Pregnancy, particularly combined with a history of infertility, confers increased risk of diabetes but not CAC among glucose-intolerant premenopausal women.
Publisher
Oxford University Press,Copyright Oxford University Press
Subject
/ Aged
/ Diabetes
/ Diabetes Mellitus, Type 2 - diagnosis
/ Diabetes Mellitus, Type 2 - epidemiology
/ Diabetes Mellitus, Type 2 - etiology
/ Diabetes Mellitus, Type 2 - prevention & control
/ Female
/ Humans
/ Infertility, Female - complications
/ Infertility, Female - epidemiology
/ Preventive Health Services - methods
/ Preventive Health Services - statistics & numerical data
/ Primary Prevention - methods
