History of spontaneous abortion may increase gestational diabetes risk in pregnant women: JAMA
China: A recent study in JAMA Network Open has revealed an association between a history of spontaneous abortion (SAB) and an increased risk of gestational diabetes (GD) in subsequent pregnancies.
"The findings of the study suggest that pregnant women having a history of SAB, particularly those with a history of recurrent SAB, should pay attention to monitoring of blood sugar and implementing early prevention of and intervention for GD," Liping Jin, Shanghai Key Laboratory of Maternal-Fetal Medicine, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China, and colleagues wrote in their study.
Among pregnant women, gestational diabetes is one of the most common and important complications. Identification of pregnant women at high risk for GD is important for implementing early prevention and intervention. Considering this, the researchers' team from China conducted a retrospective cohort study to examine whether a SAB or induced abortion history is associated with an increased GD risk in subsequent pregnancies.
The study was performed at a tertiary hospital in Shanghai, China, and included pregnant women who received routine antenatal care between January 2014 and December 2019 were included. Data analysis was performed from December 2020 to June 2021. Maternal history of abortion, including SAB and induced abortion, were extracted from medical records.
GD diagnosis was done with a 75-g diagnostic oral glucose tolerance test. Relative risks (RRs) of GD associated with a history of abortion were estimated using a multivariable-adjusted log-binomial analysis.
The study revealed the following findings:
- Among the 102 259 included pregnant women (mean age, 29.8 years), 14 579 (14.3%) experienced only SAB, 17 935 (17.5%) experienced only induced abortion, and 4017 (3.9%) experienced both SAB and induced abortion.
- A total of 12 153 GD cases were identified, and the prevalence of GD was 11.9% (12 153 of 102 259 women) in this cohort.
- Pregnant women who experienced only SAB (RR, 1.25) or both SAB and induced abortion (RR, 1.15) were at higher risk of developing GD.
- The association of SAB history with GD occurred in a number-dependent manner.
- Compared with pregnant women with no history of abortion, the RR for GD increased by 18% (RR, 1.18) for pregnant women with 1 SAB, by 41% (RR, 1.41) for those with 2 SABs, and by 43% (RR, 1.43) for those more than 2 SABs. However, no association between the history of induced abortion and GD was observed.
"Our cohort study found that a history of SAB was significantly associated with increased risk of GD in subsequent pregnancies," wrote the authors. However, they add that there is a need for further research to clarify this association and explore the potential biological mechanisms underlying the association.
Reference:
The study titled, "Association of History of Spontaneous or Induced Abortion With Subsequent Risk of Gestational Diabetes," was published in JAMA Network Open.
DOI: 10.1001/jamanetworkopen.2022.0944
