Discussion
In this study, the approximately 9% of women whose first infant was delivered preterm had excess risk of developing
T2DM, even after accounting for potential medical and lifestyle confounders. The 2% of women who experienced a
very preterm birth had a 34% increased risk of developing T2DM over the 35-year follow-up period. In an exploratory
analysis, we found that the elevation in risk first became evident at 11 to 15 years after the first pregnancy. Postterm
birth was associated with a slight, significant increase in risk of T2DM over the entire 35-year period. A history of
having borne a first infant who was term low birth weight or macrosomic conferred an almost 2 to 3-fold increased risk
of T2DM, which gradually waned over time. These findings held even after adjusting for GDM and HDOP, known
predictors of T2DM (8,20–22). If our findings are replicated in future studies, gestational age and offspring birth
weight may be useful to identify high-risk women. Our exploratory analysis , if replicated, may also provide
information on time windows in which glucose tolerance screening might be an effective addition to the primary care
of high-risk women.
DiscussionIn this study, the approximately 9% of women whose first infant was delivered preterm had excess risk of developingT2DM, even after accounting for potential medical and lifestyle confounders. The 2% of women who experienced avery preterm birth had a 34% increased risk of developing T2DM over the 35-year follow-up period. In an exploratoryanalysis, we found that the elevation in risk first became evident at 11 to 15 years after the first pregnancy. Posttermbirth was associated with a slight, significant increase in risk of T2DM over the entire 35-year period. A history ofhaving borne a first infant who was term low birth weight or macrosomic conferred an almost 2 to 3-fold increased riskof T2DM, which gradually waned over time. These findings held even after adjusting for GDM and HDOP, knownpredictors of T2DM (8,20–22). If our findings are replicated in future studies, gestational age and offspring birthweight may be useful to identify high-risk women. Our exploratory analysis , if replicated, may also provideinformation on time windows in which glucose tolerance screening might be an effective addition to the primary careof high-risk women.
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