THE ASSOCIATION BETWEEN GESTATIONAL DIABETES MELLITUS AND CARDIOVASCULAR DISEASE AND POSSIBLE MEDIATION BY TYPE 2 DIABETES MELLITUS
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This retrospective cohort study quantified the risk of subsequent cardiovascular disease (CVD) associated with gestational diabetes mellitus (GDM) and estimated the extent to which type 2 diabetes mellitus (T2DM) mediates this association. Cox regression models were used to quantify the association between GDM and CVD, while mediation analysis was used to determine whether T2DM mediates this association. Analyses used data from a linkage of the Nova Scotia Atlee Perinatal Database with administrative health databases. Among a total of 87,632 women who were included, 4.0% experienced GDM in at least one pregnancy. Women were followed for a median of 11.8 years and 1.4% developed CVD. Compared with women who did not have GDM, women with GDM had a higher risk of developing CVD [adjusted HR=1.53 (95% CI 1.23-1.91)]. T2DM mediated 93.9% of this association. These results support screening and counseling women with prior GDM to improve cardiovascular health.