Gestational Diabetes Mellitus as an Independent Predictor of Postpartum Cardiovascular Risk: A 2-Year Prospective Cohort Study

Abstract

Background: Gestational diabetes mellitus (GDM) is increasingly recognized as a predictor of long-term cardiovascular risk.

Objective: To evaluate the impact of GDM on cardiovascular risk markers over a two-year postpartum period in a prospective cohort.

Methodology: A prospective cohort study was conducted at the Department of Gynecology and Obstetrics, Liaqat Memorial Hospital Kohat, from January 2022 to December 2023. A total of 208 women between the ages of 18 and 45 who gave birth at the study center were included in the research. Pre-existing diabetes, hypertension, cardiovascular illness, renal problems, autoimmune conditions, multiple pregnancies, and insufficient follow-up were among the exclusion criteria. At six, twelve, and twenty-four months after giving birth, the participants were monitored. Blood pressure, fasting glucose, lipid profiles, anthropometric measures, and the prevalence of metabolic diseases were all noted. SPSS 26.0 was used to analyze the data, and independent t-tests, chi-square tests, and multivariate regression were used to evaluate independent relationships.

Results: Of the 208 women completing follow-up, 104 had prior GDM. GDM women had persistently higher BMI (29.12 ± 3.80 vs. 26.95 ± 3.35 kg/m², p<0.01), systolic (128.55 ± 11.05 vs. 121.12 ± 10.88 mmHg, p<0.01) and diastolic blood pressure (82.35 ± 7.88 vs. 76.88 ± 7.45 mmHg, p<0.01), fasting glucose (110.22 ± 14.12 vs. 95.88 ± 12.12 mg/dL, p<0.01), total cholesterol (215.35 ± 32.12 vs. 198.55 ± 27.88 mg/dL, p<0.01), LDL (138.22 ± 24.35 vs. 123.12 ± 22.55 mg/dL, p<0.01), triglycerides (165.35 ± 32.88 vs. 138.55 ± 30.12 mg/dL, p<0.01), and lower HDL (45.12 ± 8.55 vs. 51.12 ± 8.35 mg/dL, p<0.01) compared to controls at 24 months. Incidence of type 2 diabetes, hypertension, dyslipidemia, and metabolic syndrome was 28 (26.92%), 22 (21.15%), 35 (33.65%), and 18 (17.31%) in GDM women versus 4 (3.85%), 8 (7.69%), 12 (11.54%), and 3 (2.88%) in controls (all p<0.01).

Conclusion: GDM independently predicts sustained postpartum cardiovascular risk, highlighting the need for early monitoring and preventive strategies.