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Association between metabolic syndrome and gestational diabetes mellitus in women and their children: a systematic review and meta-analysis

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Abstract

Purpose

The primary aim of this systematic review and meta-analysis was to determine the association between gestational diabetes mellitus (GDM) and metabolic syndrome (MetS) in women and children. Our secondary aim was to assess the development of MetS with respect to the elapsed time postpartum at which MetS was diagnosed.

Methods

This review is registered with PROSPERO (CRD42020173319). PubMed, CINHAL, SCOPUS, and EMBASE databases were searched. Studies reporting on the rate of MetS in pregnant women with GDM, the rate of MetS in women with a history of GDM, and the rate of MetS in offspring exposed to GDM in utero compared to healthy controls were selected.

Results

We identified 588 articles from the literature search. Fifty-one studies were included in the review and of those 35 were included in the meta-analysis. Quantitative summary measures showed that women with a history of GDM had an increased risk of developing MetS compared to those without a history of GDM (RR 2.36, 95% CI 1.77–3.14, 29 studies, 13,390 participants; heterogeneity: χ2 p < 0.00001; I2 = 93%). Offspring exposed to GDM in utero have an increased risk of developing MetS compared to those not exposed to GDM in utero. (RR 2.07, 95% CI 1.26–3.42, three studies, 4,421 participants; heterogeneity: χ2 p = 0.33; I2 = 12%). Women diagnosed with GDM have an increased risk of developing MetS during pregnancy (RR 20.51, 95% CI 5.04–83.55; three studies, 406 participants; heterogeneity: χ2 p = 0.96; I2 = 0%). Subgroup analysis revealed that MetS is diagnosed as early as <1 year postpartum in women with a history of GDM.

Conclusions/interpretation

Women with GDM have an increased risk of developing MetS during pregnancy. Women with a history of GDM and offspring exposed to GDM in utero have higher risks of developing MetS compared to those with no history of GDM. Metabolic syndrome in women with a history of GDM is seen as early as <1 year postpartum.

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Abbreviations

MetS:

metabolic syndrome

CVD:

cardiovascular disease

GDM:

gestational diabetes mellitus

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Funding

M.M.P. is funded by Faculty of Health and Medical Sciences Divisional Scholarship from the University of Adelaide. Z.S.L. is supported by an NHMRC Public Health Early Career Fellowship (GNT1141382).

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Authors and Affiliations

  1. Adelaide Medical School and Robinson Research Institute, The University of Adelaide, Adelaide, SA, 5005, Australia

    Maleesa M. Pathirana, Zohra S. Lassi, Claire T. Roberts & Prabha H. Andraweera

  2. Faculty of Health and Medical Sciences, Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia

    Maleesa M. Pathirana, Zohra S. Lassi & Margaret A. Arstall

  3. Health Performance and Policy Research Unit, Basil Hetzel Institute, The University of Adelaide, Adelaide, SA, Australia

    Anna Ali

  4. Adelaide G-TRAC Centre and CRE Frailty and Healthy Ageing Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia

    Anna Ali

  5. Department of Cardiology, Lyell McEwin Hospital, Elizabeth Vale, SA, Australia

    Margaret A. Arstall & Prabha H. Andraweera

  6. Flinders Health and Medical Research Institute, Flinders University, Bedford Park, SA, 5042, Australia

    Claire T. Roberts

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  1. Maleesa M. Pathirana
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Contributions

M.M.P., Z.S.L., M.A.A., C.T.R., and P.H.A. designed and conceptualized this particular study. Z.S.L. designed and performed the literature search. M.M.P., Z.S.L., A.A., and P.H.A. were involved in screening and selecting the included studies. M.M.P. performed the meta-analysis with expert advice from Z.S.L. The original manuscript was drafted by M.M.P. All authors critically reviewed and revised the manuscript and approved the final version. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

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Correspondence to Prabha H. Andraweera.

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Pathirana, M.M., Lassi, Z.S., Ali, A. et al. Association between metabolic syndrome and gestational diabetes mellitus in women and their children: a systematic review and meta-analysis. Endocrine 71, 310–320 (2021). https://doi.org/10.1007/s12020-020-02492-1

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