Pregnancy loss is associated with type 2 diabetes: a nationwide case-control study.
Miscarriage
Pregnancy loss
Recurrent pregnancy loss
Reproduction
Type 2 diabetes
Journal
Diabetologia
ISSN: 1432-0428
Titre abrégé: Diabetologia
Pays: Germany
ID NLM: 0006777
Informations de publication
Date de publication:
08 2020
08 2020
Historique:
received:
28
10
2019
accepted:
10
03
2020
pubmed:
20
5
2020
medline:
12
8
2021
entrez:
20
5
2020
Statut:
ppublish
Résumé
Type 2 diabetes is killing more people than ever, and early-life predictors remain critical for the development of effective preventive strategies. Pregnancy loss is a common event associated with later atherosclerotic disease and ischaemic heart failure and might constitute a predictor for type 2 diabetes. The objective of this study was to investigate whether pregnancy loss is associated with later development of type 2 diabetes. Using a Danish nationwide cohort, we identified all women born from 1957 through to 1997 and who had a diagnosis of type 2 diabetes during the period 1977 to 2017. The women were matched 1:10 on year of birth and educational level to women without diabetes in the general Danish population. Conditional logistic regression models provided odds ratios for type 2 diabetes with different numbers of pregnancy losses. We identified 24,774 women with type 2 diabetes and selected 247,740 controls without diabetes. Women who had ever been pregnant (ever-pregnant women) with 1, 2 and ≥ 3 pregnancy losses had ORs of type 2 diabetes of 1.18 (95% CI 1.13, 1.23), 1.38 (95% CI 1.27, 1.49) and 1.71 (95% CI 1.53, 1.92) compared with ever-pregnant women with no pregnancy losses, respectively. Women who never achieved a pregnancy had an OR of type 2 diabetes of 1.56 (95% CI 1.51, 1.61) compared with ever-pregnant women with any number of losses. Similar results were found after adjustment for obesity and gestational diabetes. We found a significant and consistent association between pregnancy loss and later type 2 diabetes that increased with increasing number of losses. Thus, pregnancy loss and recurrent pregnancy loss are significant risk factors for later type 2 diabetes. Future studies should explore whether this association is due to common background factors or whether prediabetic metabolic conditions are responsible for this association. Graphical abstract.
Identifiants
pubmed: 32424542
doi: 10.1007/s00125-020-05154-z
pii: 10.1007/s00125-020-05154-z
doi:
Types de publication
Case Reports
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1521-1529Subventions
Organisme : Nove Nordisk Foundation
ID : NNF18SA0034956
Pays : International
Références
World Health Organization (2018) Diabetes fact sheet. Available from http://www.who.int/news-room/fact-sheets/detail/diabetes . Assesed 15 Jan 2019
Abbasi A, Peelen LM, Corpeleijn E et al (2012) Prediction models for risk of developing type 2 diabetes: systematic literature search and independent external validation study. BMJ 345:e5900. https://doi.org/10.1136/bmj.e5900
doi: 10.1136/bmj.e5900
pubmed: 22990994
pmcid: 3445426
Foghsgaard S, Vedtofte L, Andreasen C et al (2017) Women with prior gestational diabetes mellitus and prediabetes are characterised by a decreased incretin effect. Diabetologia 60(7):1344–1353. https://doi.org/10.1007/s00125-017-4265-8
doi: 10.1007/s00125-017-4265-8
pubmed: 28364253
Macklon NS, Geraedts JP, Fauser BC (2002) Conception to ongoing pregnancy: the 'black box' of early pregnancy loss. Hum Reprod Update 8(4):333–343. https://doi.org/10.1093/humupd/8.4.333
doi: 10.1093/humupd/8.4.333
pubmed: 12206468
Martin JA, Hamilton BE, Osterman MJ, Driscoll AK, Mathews TJ (2017) Births: final data for 2015. Natl Vital Stat Rep 66(1):1 Available from https://www.cdc.gov/nchs/data/nvsr/nvsr66/nvsr66_01.pdf . Assesed 15 Jan 2019
pubmed: 28135188
Kolte AM, Bernardi LA, Christiansen OB et al (2015) Terminology for pregnancy loss prior to viability: a consensus statement from the ESHRE early pregnancy special interest group. Hum Reprod 30(3):495–498. https://doi.org/10.1093/humrep/deu299
doi: 10.1093/humrep/deu299
pubmed: 25376455
Hardy K, Hardy PJ, Jacobs PA, Lewallen K, Hassold TJ (2016) Temporal changes in chromosome abnormalities in human spontaneous abortions: results of 40 years of analysis. Am J Med Genet A 170(10):2671–2680. https://doi.org/10.1002/ajmg.a.37795
doi: 10.1002/ajmg.a.37795
pubmed: 27287007
Ogasawara M, Aoki K, Okada S, Suzumori K (2000) Embryonic karyotype of abortuses in relation to the number of previous miscarriages. Fertil Steril 73(2):300–304. https://doi.org/10.1016/S0015-0282(99)00495-1
doi: 10.1016/S0015-0282(99)00495-1
pubmed: 10685533
Lund M, Kamper-Jorgensen M, Nielsen HS, Lidegaard O, Andersen AM, Christiansen OB (2012) Prognosis for live birth in women with recurrent miscarriage: what is the best measure of success? Obstet Gynecol 119(1):37–43. https://doi.org/10.1097/AOG.0b013e31823c0413
doi: 10.1097/AOG.0b013e31823c0413
pubmed: 22183209
Royal College of Obstetricians and Gynaecologists (2011) The investigation and treatment of couples with recurrent first-trimester and second-trimester miscarriage. Green-top Guideline No 17. Available from https://www.rcog.org.uk/globalassets/documents/guidelines/gtg_17.pdf . Accessed 15 Jan 2019
Danish Society of Obstetrics and Gynecology (2019) National recurrent pregnancy loss guideline. DSOG, Copenhagen
Christiansen OB, Nielsen HS, Kolte AM (2006) Inflammation and miscarriage. Semin Fetal Neonatal Med 11(5):302–308. https://doi.org/10.1016/j.siny.2006.03.001
doi: 10.1016/j.siny.2006.03.001
pubmed: 16682265
Christiansen OB, Nielsen HS, Lund M, Steffensen R, Varming K (2009) Mannose-binding lectin-2 genotypes and recurrent late pregnancy losses. Hum Reprod 24(2):291–299. https://doi.org/10.1093/humrep/den377
doi: 10.1093/humrep/den377
pubmed: 18927129
Kolte AM, Steffensen R, Christiansen OB, Nielsen HS (2016) Maternal HY-restricting HLA class II alleles are associated with poor long-term outcome in recurrent pregnancy loss after a boy. Am J Reprod Immunol 76(5):400–405. https://doi.org/10.1111/aji.12561
doi: 10.1111/aji.12561
pubmed: 27600856
Kolte AM, Steffensen R, Nielsen HS, Hviid TV, Christiansen OB (2010) Study of the structure and impact of human leukocyte antigen (HLA)-G-A, HLA-G-B, and HLA-G-DRB1 haplotypes in families with recurrent miscarriage. Hum Immunol 71(5):482–488. https://doi.org/10.1016/j.humimm.2010.02.001
doi: 10.1016/j.humimm.2010.02.001
pubmed: 20149831
Lund M, Nielsen HS, Hviid TV, Steffensen R, Nyboe Andersen A, Christiansen OB (2010) Hereditary thrombophilia and recurrent pregnancy loss: a retrospective cohort study of pregnancy outcome and obstetric complications. Hum Reprod 25(12):2978–2984. https://doi.org/10.1093/humrep/deq280
doi: 10.1093/humrep/deq280
pubmed: 20937743
Nielsen HS (2011) Secondary recurrent miscarriage and H-Y immunity. Hum Reprod Update 17(4):558–574. https://doi.org/10.1093/humupd/dmr005
doi: 10.1093/humupd/dmr005
pubmed: 21482560
Nielsen HS, Christiansen OB (2005) Prognostic impact of anticardiolipin antibodies in women with recurrent miscarriage negative for the lupus anticoagulant. Hum Reprod 20(6):1720–1728. https://doi.org/10.1093/humrep/deh790
doi: 10.1093/humrep/deh790
pubmed: 15774545
Nielsen HS, Steffensen R, Varming K et al (2009) Association of HY-restricting HLA class II alleles with pregnancy outcome in patients with recurrent miscarriage subsequent to a firstborn boy. Hum Mol Genet 18(9):1684–1691. https://doi.org/10.1093/hmg/ddp077
doi: 10.1093/hmg/ddp077
pubmed: 19223392
Nielsen HS, Witvliet MD, Steffensen R et al (2010) The presence of HLA-antibodies in recurrent miscarriage patients is associated with a reduced chance of a live birth. J Reprod Immunol 87(1–2):67–73. https://doi.org/10.1016/j.jri.2010.05.006
doi: 10.1016/j.jri.2010.05.006
pubmed: 20605049
Nielsen HS, Steffensen R, Lund M et al (2010) Frequency and impact of obstetric complications prior and subsequent to unexplained secondary recurrent miscarriage. Hum Reprod 25(6):1543–1552. https://doi.org/10.1093/humrep/deq091
doi: 10.1093/humrep/deq091
pubmed: 20395221
Kruse C, Steffensen R, Varming K, Christiansen OB (2004) A study of HLA-DR and -DQ alleles in 588 patients and 562 controls confirms that HLA-DRB1*03 is associated with recurrent miscarriage. Hum Reprod 19(5):1215–1221. https://doi.org/10.1093/humrep/deh200
doi: 10.1093/humrep/deh200
pubmed: 15070884
Christiansen OB, Kolte AM, Nielsen HS (2006) Secondary recurrent miscarriage - a unique entity with respect to etiology and treatment. Current Women’s Health Reviews 2(2):119–124. https://doi.org/10.2174/157340406776931089
doi: 10.2174/157340406776931089
Smith GC, Pell JP, Walsh D (2003) Spontaneous loss of early pregnancy and risk of ischaemic heart disease in later life: retrospective cohort study. BMJ 326(7386):423–424. https://doi.org/10.1136/bmj.326.7386.423
doi: 10.1136/bmj.326.7386.423
pubmed: 12595381
pmcid: 149442
Ranthe MF, Andersen EA, Wohlfahrt J, Bundgaard H, Melbye M, Boyd HA (2013) Pregnancy loss and later risk of atherosclerotic disease. Circulation 127(17):1775–1782. https://doi.org/10.1161/CIRCULATIONAHA.112.000285
doi: 10.1161/CIRCULATIONAHA.112.000285
pubmed: 23536362
Ranthe MF, Boyd HA (2015) Miscarriage and cardiovascular disease. Heart 101(24):1933–1934. https://doi.org/10.1136/heartjnl-2015-308383
doi: 10.1136/heartjnl-2015-308383
pubmed: 26385454
Horn J, Tanz LJ, Stuart JJ et al (2018) Early or late pregnancy loss and development of clinical cardiovascular disease risk factors: a prospective cohort study. BJOG 126(1):33–42. https://doi.org/10.1111/1471-0528.15452
doi: 10.1111/1471-0528.15452
pubmed: 30144277
pmcid: 6294683
Kharazmi E, Lukanova A, Teucher B, Gross ML, Kaaks R (2012) Does pregnancy or pregnancy loss increase later maternal risk of diabetes? Eur J Epidemiol 27(5):357–366. https://doi.org/10.1007/s10654-012-9683-9
doi: 10.1007/s10654-012-9683-9
pubmed: 22539240
Pedersen CB (2011) The Danish civil registration system. Scand J Public Health 39(Suppl 7):22–25. https://doi.org/10.1177/1403494810387965
doi: 10.1177/1403494810387965
pubmed: 21775345
Schmidt M, Schmidt SA, Sandegaard JL, Ehrenstein V, Pedersen L, Sorensen HT (2015) The Danish National Patient Registry: a review of content, data quality, and research potential. Clin Epidemiol 7:449–490. https://doi.org/10.2147/CLEP.S91125
doi: 10.2147/CLEP.S91125
pubmed: 26604824
pmcid: 4655913
Bliddal M, Broe A, Pottegard A, Olsen J, Langhoff-Roos J (2018) The Danish Medical Birth Register. Eur J Epidemiol 33(1):27–36. https://doi.org/10.1007/s10654-018-0356-1
doi: 10.1007/s10654-018-0356-1
pubmed: 29349587
Kildemoes HW, Sorensen HT, Hallas J (2011) The Danish National Prescription Registry. Scand J Public Health 39(7 Suppl):38–41. https://doi.org/10.1177/1403494810394717
doi: 10.1177/1403494810394717
pubmed: 21775349
The Danish Health Data Authority. Algorithm for selected chronic diseases and severe psychiatric diagnoses. 2018. Available from https://www.esundhed.dk/Registre/Register-for-udvalgte-kroniske-sygdomme#tabpanel988928C7E4B84712940C30D63EC7544C . Assesed 15 Oct 2018
Zhang C, Olsen SF, Hinkle SN et al (2019) Diabetes & Women’s Health (DWH) Study: an observational study of long-term health consequences of gestational diabetes, their determinants and underlying mechanisms in the USA and Denmark. BMJ Open 9(4):e025517. https://doi.org/10.1136/bmjopen-2018-025517
doi: 10.1136/bmjopen-2018-025517
pubmed: 31048434
pmcid: 6502016
American Diabetes Association (2019) Management of diabetes in pregnancy: standards of medical care in diabetes—2019. Diabetes Care 42(Suppl 1):S165–S172. https://doi.org/10.2337/dc19-S014
doi: 10.2337/dc19-S014
Maryam K, Bouzari Z, Basirat Z, Kashifard M, Zadeh MZ (2012) The comparison of insulin resistance frequency in patients with recurrent early pregnancy loss to normal individuals. BMC Res Notes 5(1):133. https://doi.org/10.1186/1756-0500-5-133
doi: 10.1186/1756-0500-5-133
pubmed: 22405326
pmcid: 3329408
Craig LB, Ke RW, Kutteh WH (2002) Increased prevalence of insulin resistance in women with a history of recurrent pregnancy loss. Fertil Steril 78(3):487–490. https://doi.org/10.1016/s0015-0282(02)03247-8
doi: 10.1016/s0015-0282(02)03247-8
pubmed: 12215322
Zolghadri J, Tavana Z, Kazerooni T, Soveid M, Taghieh M (2008) Relationship between abnormal glucose tolerance test and history of previous recurrent miscarriages, and beneficial effect of metformin in these patients: a prospective clinical study. Fertil Steril 90(3):727–730. https://doi.org/10.1016/j.fertnstert.2007.06.079
doi: 10.1016/j.fertnstert.2007.06.079
pubmed: 18001723
Wang Y, Zhao H, Li Y, Zhang J, Tan J, Liu Y (2011) Relationship between recurrent miscarriage and insulin resistance. Gynecol Obstet Investig 72(4):245–251. https://doi.org/10.1159/000325165
doi: 10.1159/000325165
Dayan N, Filion KB, Okano M et al (2017) Cardiovascular risk following fertility therapy: systematic review and meta-analysis. J Am Coll Cardiol 70(10):1203–1213. https://doi.org/10.1016/j.jacc.2017.07.753
doi: 10.1016/j.jacc.2017.07.753
pubmed: 28859782
Lohse SR, Farkas DK, Lohse N et al (2010) Validation of spontaneous abortion diagnoses in the Danish National Registry of Patients. Clin Epidemiol 2:247–250. https://doi.org/10.2147/CLEP.S13815
doi: 10.2147/CLEP.S13815
pubmed: 21152251
pmcid: 2998814
Nielsen GL, Sorensen HT, Pedersen AB, Sabroe S (1996) Analyses of data quality in registries concerning diabetes mellitus--a comparison between a population based hospital discharge and an insulin prescription registry. J Med Syst 20(1):1–10. https://doi.org/10.1007/BF02260869
doi: 10.1007/BF02260869
pubmed: 8708487