Higher Maternal Age Increases Risk of Gestational Diabetes at All Stages, suggests study

GDM is a serious complication of pregnancy and may predispose mothers to certain complications, especially in the neonate. Early GDM, diagnosed at or before 24 weeks of gestation, and late GDM, diagnosed after 24 weeks of gestation, both demonstrate a sharp increase with advancing maternal age.

This cohort prospective study analyzed the data of 72,270 pregnant women and examined the risk of GDM in relation to maternal age. GDM was classified into:

• Early GDM: Diagnosed at less than 24 gestational weeks

• Late GDM: Diagnosed at or after 24 gestational weeks

Maternal age was grouped into <30, 30-34.9 (referent group), 35-39.9, and ≥40 years. A multinomial logistic regression model was applied for the analysis to assess the association while adjusting for potential confounding variables.

Results

Higher maternal age was associated with significantly increased odds of both early and late GDM (P-value for trend <0.0001 for both).

Early GDM

• Maternal age 35-39.9 years : aOR = 1.399; (95% CI: 1.134–1.725)

• Maternal age ≥40 years : aOR = 2.494; (95% CI: 1.828–3.402)

Late GDM

• Maternal age 35-39.9 years: aOR 1.603; (95% CI: 1.384–1.857)

• Maternal age ≥40 years : aOR 2.276; (95% CI: 1.798–2.881)

Relative Risk by Age Group

• Women aged ≥40 were more than 2.4 times likely to have early GDM and 2.2 times more likely to have late GDM compared to those aged 30-34.9 years.

Discussion

There was a constant and significant correlation between the high risk of advanced maternal age with GDM risk, irrespective of the gestational stage at the time of diagnosis. The said trend emphasizes that physiological changes like reduced insulin sensitivity and metabolic adjustments during pregnancy might contribute to such age-related increases.

Critical similarity between early and late GDM is the proximity in risk. This calls for constant surveillance of glucose levels during the pregnancy duration, especially in women of 35 years and above. Determined interventions for such populations, like an early screen and lifestyle changes, may reduce the risks.

Higher maternal age has been found to significantly increase the risk of GDM both in early and late pregnancy. A woman is more likely to suffer from GDM if she is 35 years or older. This underscores a higher need for monitoring and early intervention for better maternal and neonatal outcomes.

Reference:

Tagami K, Iwama N, Hamada H, Tomita H, Kudo R, Kumagai N, Wang H, Izumi S, Watanabe Z, Ishikuro M, Obara T, Metoki H, Miura Y, Ota C, Sugiyama T, Kuriyama S, Arima T, Yaegashi N, Saito M; Japan Environment and Children's Study Group. Advanced maternal age is a risk factor for both early and late gestational diabetes mellitus: The Japan Environment and Children's Study. J Diabetes Investig. 2025 Jan 11. doi: 10.1111/jdi.14400. Epub ahead of print. PMID: 39797691.