Women with Gestational Diabetes Face Greater Chances of Developing Kidney Disease Later in Life: Meta-Analysis
China: A new meta-analysis published in the Journal of Diabetes and Its Complications has revealed that women who develop gestational diabetes mellitus (GDM) during pregnancy face a substantially higher risk of developing chronic kidney disease (CKD) later in life.
The study, led by Qin Zhou and colleagues from the Kidney Disease Center at The First Affiliated Hospital, Zhejiang University School of Medicine, China, analyzed data from over 21 million pregnancies to better understand this connection.
Gestational diabetes, a form of glucose intolerance first identified during pregnancy, has long been associated with an elevated risk of developing type 2 diabetes in later years. However, its impact on kidney health has remained uncertain. This meta-analysis provides stronger evidence that GDM itself may contribute to future kidney complications, independent of other factors.
The investigators systematically reviewed data from eight studies retrieved from PubMed, Embase, and the Cochrane Library up to May 2025. Collectively, these studies included 21,806,683 pregnant women.
The researchers reported the following findings:
- Women with a history of gestational diabetes mellitus (GDM) had a 79% higher risk of developing chronic kidney disease (CKD) compared to those without GDM.
- High-quality studies and analyses adjusted for key confounding factors showed an even stronger association, with more than a 2.5-fold higher risk (odds ratio ~2.76).
- The pooled analysis confirmed a significant link between GDM and CKD (OR = 1.79).
- Subgroup analyses restricted to high-quality and adjusted studies consistently supported the observed association.
The authors emphasized that although the findings were statistically significant, the degree of variation (heterogeneity) among the included studies was high, suggesting that differences in study design, population characteristics, or follow-up duration may have influenced the results.
Dr. Zhou and colleagues suggested that long-term renal monitoring of women who experienced GDM could play a key role in the early detection and prevention of CKD. Given that both diabetes and kidney disease are chronic conditions with major public health implications, early intervention may help reduce future complications.
While the biological mechanisms linking GDM to CKD are still being explored, the researchers proposed several possibilities. Shared metabolic pathways, including insulin resistance, inflammation, and vascular dysfunction, may predispose women with GDM to progressive kidney damage over time. Additionally, persistent glucose abnormalities after pregnancy might accelerate renal decline.
The study emphasizes the importance of considering GDM not just as a temporary pregnancy-related condition but as a potential early warning marker for long-term kidney health. The authors called for more prospective studies to clarify the underlying mechanisms and to establish optimal strategies for monitoring and managing kidney function in women with a history of gestational diabetes.
"The comprehensive analysis highlights a significant and consistent association between gestational diabetes and an elevated risk of chronic kidney disease, reinforcing the need for ongoing surveillance and preventive care in this high-risk group," the authors concluded.
Reference:
Zhou, Q., Yang, H., Xie, X., & Wang, R. (2025). Gestational diabetes mellitus and the subsequent risk of chronic kidney disease: A systematic review and meta-analysis. Journal of Diabetes and its Complications, 109197. https://doi.org/10.1016/j.jdiacomp.2025.109197
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