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The association between a history of gestational diabetes mellitus and future risk for female malignancies

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objective

To investigate whether patients with a history of gestational diabetes mellitus (GDM) have an increased future risk for female malignancies.

Study design

A population-based study compared the incidence of long-term female malignancies (ovary, uterine, breast, and uterine cervix) in a cohort of women with and without a diagnosis of GDM. Deliveries occurred between the years 1988–2013, with a mean follow-up duration of 12 years. Women with known malignancies prior to the index pregnancy were excluded. Kaplan–Meier survival curve was used to estimate cumulative incidence of malignancies. Cox proportional hazards models were used to estimate the adjusted hazard ratios (HR) for female malignancy.

Results

During the study period, 1,04,715 deliveries met the inclusion criteria; 9.4% (n = 9893) occurred in patients with a history of GDM in at least one of their pregnancies. During the follow-up period, patients with GDM had a significantly increased risk of being diagnosed with female malignancies, including ovarian, uterine, and breast cancer. Using a Kaplan–Meier survival curve, patients with a previous diagnosis of GDM had a significantly higher cumulative incidence of female malignancies. Using a Cox proportional hazards model, adjusted for confounders, such as parity, maternal age, and fertility treatments, a history of GDM remained independently associated with female malignancies (adjusted HR, 1.3; 95% CI 1.2–1.6; P = 0.001).

Conclusion

Patients with a history of GDM have an increased risk for future breast, ovarian, and uterine malignancies.

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Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, POB 151, 84101, Beer Sheva, Israel

    Oded Fuchs, Eyal Sheiner, Mihai Meirovitz & Roy Kessous

  2. Department of Public Health, Ben-Gurion University of the Negev, Beer-Sheva, Israel

    Ruslan Sergienko

  3. Soroka University Medical Center, Clalit Health Services (Southern District), Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel

    Ehud Davidson

Authors
  1. Oded Fuchs
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  2. Eyal Sheiner
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  3. Mihai Meirovitz
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  4. Ehud Davidson
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  5. Ruslan Sergienko
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  6. Roy Kessous
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Corresponding author

Correspondence to Eyal Sheiner.

Ethics declarations

Conflict of interest

The authors report no conflict of interest.

Funding

This study was not funded by any grant.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Appendix

Appendix

Dig

ICD code

diagnosis

OVARY

7300

V1043

PERSONAL HISTORY OF MALIGNANT NEOPLASM OF OVARY

21899

183

MALIGNANT NEOPLASM OF OVARY AND OTHER UTERINE ADNEXA

21900

1830

MALIGNANT NEOPLASM OF OVARY

21901

1832

MALIGNANT NEOPLASM OF OVARY

21905

1838

MALIGNANT NEOPLASM OF OTHER SPECIFIED SITES OF UTERINE ADNEXA

21906

1839

MALIGNANT NEOPLASM OF UTERINE ADNEXA, UNSPECIFIED

21758

1588

MALIGNANT NEOPLASM OF SPECIFIED PARTS OF PERITONEUM

21759

1589

MALIGNANT NEOPLASM OF PERITONEUM, UNSPECIFIED

UTERUS

22575

2332

CARCINOMA IN SITU OF OTHER AND UNSPECIFIED PARTS OF UTERUS

21895

182

MALIGNANT NEOPLASM OF BODY OF UTERUS

21896

1820

MALIGNANT NEOPLASM OF CORPUS UTERI, EXCEPT ISTHMUS

21897

1821

MALIGNANT NEOPLASM OF ISTHMUS

21898

1828

MALIGNANT NEOPLASM OF OTHER SPECIFIED SITES OF BODY OF UTERUS

21888

179

MALIGNANT NEOPLASM OF UTERUS, PART UNSPECIFIED

7299

V1042

PERSONAL HISTORY OF MALIGNANT NEOPLASM OF OTHER PARTS OF UTERUS

CERVICAL CA

22575

2331

CARCINOMA IN SITU OF CERVIX UTERI

7928

V1041

PERSONAL HISTORY OF MALIGNANT NEOPLASM OF CERVIX UTERI

21889

180

MALIGNANT NEOPLASM OF CERVIX UTERI

21890

1800

MALIGNANT NEOPLASM OF ENDOCERVIX

21891

1801

MALIGNANT NEOPLASM OF EXOCERVIX

21892

1808

MALIGNANT NEOPLASM OF OTHER SPECIFIED SITES OF CERVIX

BREAST CA

7295

V103

PERSONAL HISTORY OF MALIGNANT NEOPLASM OF BREAST

22574

2330

CARCINOMA IN SITU OF BREAST

22630

2383

NEOPLASM OF UNCERTAIN BEHAVIOR OF BREAST

22642

2393

NEOPLASM OF UNSPECIFIED NATURE OF BREAST

21857

174

MALIGNANT NEOPLASM OF FEMALE BREAST

21858

1740

MALIGNANT NEOPLASM OF NIPPLE AND AREOLA OF FEMALE BREAST

21859

1741

MALIGNANT NEOPLASM OF CENTRAL PORTION OF FEMALE BREAST

21860

1742

MALIGNANT NEOPLASM OF UPPER-INNER QUADRANT OF FEMALE BREAST

21861

1743

MALIGNANT NEOPLASM OF LOWER-INNER QUADRANT OF FEMALE BREAST

21862

1744

MALIGNANT NEOPLASM OF UPPER-OUTER QUADRANT OF FEMALE BREAST

21863

1745

MALIGNANT NEOPLASM OF LOWER-OUTER QUADRANT OF FEMALE BREAST

21864

1746

MALIGNANT NEOPLASM OF AXILLARY TAIL OF FEMALE BREAST

21865

1747

MALIGNANT NEOPLASM OF OTHER SPECIFIED SITES OF FEMALE BREAST

21866

1748

MALIGNANT NEOPLASM OF BREAST (FEMALE), UNSPECIFIED

SURGERY PROCEDUREFOR BREAST CA

1182-1183

Z8521

LOCAL EXCISION OF LESION OF BREAST

1184

Z85210

LOCAL EXC.BREAST LESION + REG. LYMPH NODE EXC.

1185

Z85211

LOCAL EXC. BREAST LESION + RAD. CERVICAL NODE EXC.

1186

Z8522

RESECTION OF QUADRANT OF BREAST

1187

Z85220

QUADRANT RESECT.BREAST+RAD.CERVICAL NODE EXC.

1188

Z85221

QUADRANT RESECT.BREAST`REGIONAL LYMPH NODE EXC.

1189

Z8523

SUBTOTAL MASTECTOMY

1199

Z854

MASTECTOMY

1200

Z8541

UNILATERAL SIMPLE MASTECTOMY

1201

Z8542

BILATERAL SIMPLE MASTECTOMY

1202

Z8543

UNILATERAL EXTENDED SIMPLE MASTECTOMY

1203

Z85430

RADICAL MODIFIED MASTECTOMY

1204

Z8544

BILATERAL EXTENDED SIMPLE MASTECTOMY

1205

Z8545

UNILATERAL RADICAL MASTECTOMY

1206

Z8546

BILATERAL RADICAL MASTECTOMY

1207

Z8547

UNILATERAL EXTENDED RADICAL MASTECTOMY

1208

Z8548

BILATERAL EXTENDED RADICAL MASTECTOMY

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Fuchs, O., Sheiner, E., Meirovitz, M. et al. The association between a history of gestational diabetes mellitus and future risk for female malignancies. Arch Gynecol Obstet 295, 731–736 (2017). https://doi.org/10.1007/s00404-016-4275-7

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  • DOI: https://doi.org/10.1007/s00404-016-4275-7

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