Objective
We sought to prospectively examine whether childbearing is associated with higher
incidence of the metabolic syndrome (MetS) after delivery among women of reproductive
age.
Study Design
In 1451 nulliparas who were aged 18-30 years and free of the MetS at baseline (1985-1986)
and reexamined up to 4 times during 20 years, we ascertained incident MetS defined
by the National Cholesterol Education Program Adult Treatment Panel III criteria among
time-dependent interim birth groups by gestational diabetes mellitus (GDM): (0 [referent],
1 non-GDM, 2+ non-GDM, 1+ GDM births). Complementary log-log models estimated relative
hazards of the MetS among birth groups adjusted for race, age, and baseline and follow-up
covariates.
Results
We identified 259 incident MetS cases in 25,246 person-years (10.3/1000 person-years).
Compared with 0 births, adjusted relative hazards (95% confidence interval [CI]) were
1.33 (95% CI, 0.93-1.90) for 1 non-GDM, 1.62 (95% CI, 1.16-2.26) for 2+ non-GDM (P trend = .02), and 2.43 (95% CI, 1.53-3.86) for 1+ GDM births.
Conclusion
Increasing parity is associated with future development of the MetS independent of
prior obesity and pregnancy-related weight gain. Risk varies by GDM status.
Key words
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Article info
Publication history
Published online: June 29, 2009
Accepted:
March 23,
2009
Received in revised form:
November 28,
2008
Received:
July 29,
2008
Footnotes
Cite this article as: Gunderson EP, Jacobs DR, Chiang V, et al. Childbearing is associated with higher incidence of the metabolic syndrome among women of reproductive age controlling for measurements before pregnancy: the CARDIA study. Am J Obstet Gynecol 2009;201:177.e1-9.
Reprints not available from the authors.
This study was supported by the National Institutes of Health (contracts N01-HC-48047, N01-HC-48048, N01-HC-48049, N01-HC-48050, and N01-HC-95095 from the National Heart, Lung, and Blood Institute and the Career Development Award, Grant K01 DK059944, from the National Institute of Diabetes, Digestive and Kidney Diseases) and a Research Award from the American Diabetes Association.
Identification
Copyright
© 2009 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
