Infertility, Gravidity, and Risk Of Diabetes among High-Risk Women in the Diabetes Prevention Program Outcomes Study

Publication Description
OBJECTIVE: The extent to which infertility and pregnancy independently increase risk of diabetes and subclinical atherosclerosis is not known. RESEARCH DESIGN AND METHODS: We conducted a secondary analysis of Diabetes Prevention Program (DPP) and the DPP Outcomes Study over a 15-year period. We included women who answered questions about gravidity and infertility at baseline (n = 2085). Infertility was defined as > 1 year of unsuccessful attempts to conceive; thus, women could have histories of infertility as well as pregnancy. Risk of diabetes associated with gravidity and infertility was calculated using Cox proportional hazards models adjusting for age, race/ethnicity, treatment arm, body mass index, and pregnancy during the study. Among women who underwent assessment of coronary artery calcification (CAC) (n = 1337), odds of CAC were calculated using logistic regression models with similar covariates. RESULTS: Among premenopausal women (n = 1075), women with histories of pregnancy and infertility (n = 147; hazard ratio [HR] 1.80; 95% confidence interval [CI] 1.30, 2.49) and women with histories of pregnancy without infertility (n = 736; HR 1.49; 95% CI 1.15, 1.93) had greater diabetes risk than nulligravid women without infertility (n = 173). Premenopausal nulligravid women with histories of infertility had a non-significant elevation in risk, although the number of these women was small (n = 19; HR 1.63; 95% CI 0.88, 3.03). Associations were not observed among postmenopausal women (n = 1010). No associations were observed between infertility or pregnancy with CAC. CONCLUSIONS: Pregnancy, particularly combined with a history of infertility, confers increased risk of diabetes but not CAC among glucose-intolerant premenopausal women.

Primary Author
Kim,C.
Younes,N.
Temprosa,M.
Edelstein,S.
Goldberg,R. B.
Araneta,M. G.
Wallia,A.
Brown,A.
Darwin,C.
Ibebuogu,U.
Pi-Sunyer,X.
Knowler,W. C.

Author Address
Departments of Medicine, Obstetrics & Gynecology, and Epidemiology, University of Michigan, Ann Arbor, Michigan.; Biostatistics Center, George Washington University, Rockville, Maryland.; Biostatistics Center, George Washington University, Rockv(TRUNCATED)

Volume
105

Issue
3

Start Page
e358

Other Pages
e367

Author Address
Departments of Medicine, Obstetrics & Gynecology, and Epidemiology, University of Michigan, Ann Arbor, Michigan.; Biostatistics Center, George Washington University, Rockville, Maryland.; Biostatistics Center, George Washington University, Rockv(TRUNCATED)

PMID
31955207

PMCID
PMC7007766



Reference Type
Journal Article

Periodical Full
The Journal of clinical endocrinology and metabolism

Publication Year
2020

Publication Date
1-Mar

Place of Publication
United States

ISSN/ISBN
1945-7197

Document Object Index
10.1210/clinem/dgaa013

Accession Number
PMID: 31955207