Conjoint association of gestational diabetes mellitus and hypertensive disorders of pregnancy with long-term risk of mortality: a population-based cohort study.

BACKGROUND

Gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDPs) are common maternal complications. We sought to evaluate the independent and joint association of GDM and HDPs with all-cause, premature, and cause-specific mortality.

METHODS

We used data from the UK Biobank, which included 220 953 women who reported at least one live birth. Individual and joint associations of GDM and HDPs with all-cause, premature, and cause-specific mortality were estimated using Cox regression models.

RESULTS

During a follow-up of 12.9 years, women who experienced GDM had a higher risk of all-cause (hazard ratio (HR) = 1.57; 95% confidence interval (CI) = 1.26-1.96), premature (HR = 1.60; 95% CI = 1.24-2.06) and cardiovascular disease (CVD) mortality (HR = 2.60; 95% CI = 1.70-3.96). Women with a history of HDPs had an increased risk for CVD mortality (HR = 2.07; 95% CI = 1.51-2.83), but the association with all-cause death and premature death was not significant. Individuals who encountered both GDM and HDPs had a 3.9-fold higher relative risk of all-cause mortality (HR = 3.93; 95% CI = 1.88-8.24]) and a 4.3-fold higher risk of premature mortality (HR = 4.31; 95% CI = 1.94-9.57), compared to those without GDM or HDPs.

CONCLUSIONS

Women with GDM have a higher risk of all-cause, premature mortality and both risks were higher than the impacts of a history of HDPs based on a large-scale population. The co-occurrence of GDM and HDPs will deteriorate the aforementioned situation compared to a single cardiometabolic pregnancy complication.