{"doi":"10.1055/a-1970-7892","title":"Long-Term Maternal Metabolic and Cardiovascular Phenotypes after a Pregnancy Complicated by Mild Gestational Diabetes Mellitus or Obesity","abstract":"OBJECTIVE: The aim of this study was to evaluate the association of mild gestational diabetes mellitus (GDM) and obesity with metabolic and cardiovascular markers 5 to 10 years after pregnancy. STUDY DESIGN: This was a secondary analysis of 5- to 10-year follow-up study of a mild GDM treatment trial and concurrent observational cohort of participants ineligible for the trial with abnormal 1-hour glucose challenge test only. Participants with 2-hour glucose tolerance test at follow-up were included. The primary exposures were mild GDM and obesity. The outcomes were insulinogenic index (IGI), 1/homeostatic model assessment of insulin resistance (HOMA-IR), and cardiovascular markers vascular endothelial growth factor, (VEGF), vascular cell adhesion molecule 1 (VCAM-1), cluster of differentiation 40 ligand (CD40L), growth differentiation factor 15 (GDF-15), and suppression of tumorgenesis 2 (ST-2). Multivariable linear regression estimated the association of GDM and obesity with biomarkers. RESULTS: Of 951 participants in the parent study, 642 (68%) were included. Lower 1/HOMA-IR were observed in treated and untreated GDM groups, compared with non-GDM (mean differences, -0.24 and -0.15; 95% confidence intervals [CIs], -0.36 to -0.12 and -0.28 to -0.03, respectively). Lower VCAM-1 (angiogenesis) was observed in treated GDM group (mean difference, -0.11; 95% CI, -0.19 to -0.03). GDM was not associated with IGI or other biomarkers. Obesity was associated with lower 1/HOMA-IR (mean difference, -0.42; 95% CI, -0.52 to -0.32), but not other biomarkers. CONCLUSION: Prior GDM and obesity are associated with more insulin resistance but not insulin secretion or consistent cardiovascular dysfunction 5 to 10 years after delivery. KEY POINTS: · Mild GDM increases the risk of insulin resistance 5 to 10 years postpartum but not pancreatic dysfunction.. · Obesity increases the risk of insulin resistance 5 to 10 years postpartum but not pancreatic dysfunction.. · Neither mild GDM nor obesity increased the risk of cardiovascular dysfunction 5 to 10 years postpartum..","journal":"American Journal of Perinatology","year":2022,"id":268362,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":5,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.947,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":515119,"name":"Lisa Mele","orcid":"0000-0002-4471-9725","position":1,"is_corresponding":false},{"id":319134,"name":"Mark B. Landon","orcid":null,"position":2,"is_corresponding":false},{"id":388820,"name":"Michael W. Varner","orcid":"0000-0001-9455-3973","position":3,"is_corresponding":false},{"id":372222,"name":"Brian M. Casey","orcid":"0000-0001-5452-3761","position":4,"is_corresponding":false},{"id":262907,"name":"Uma M. Reddy","orcid":"0000-0001-5519-1527","position":5,"is_corresponding":false},{"id":262909,"name":"Ronald J. Wapner","orcid":"0000-0003-0727-1244","position":6,"is_corresponding":false},{"id":460635,"name":"Dwight J. Rouse","orcid":"0000-0002-9336-9688","position":7,"is_corresponding":false},{"id":377145,"name":"John M. Thorp","orcid":"0000-0002-4598-0271","position":8,"is_corresponding":false},{"id":435582,"name":"Edward K. Chien","orcid":"0000-0003-3268-0111","position":9,"is_corresponding":false},{"id":716226,"name":"George Saade","orcid":null,"position":10,"is_corresponding":false},{"id":460639,"name":"Beth A. Plunkett","orcid":"0000-0003-1712-2226","position":11,"is_corresponding":false},{"id":517027,"name":"Sean C. Blackwell","orcid":null,"position":12,"is_corresponding":false},{"id":930523,"name":"for the Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units (MFMU) Network","orcid":null,"position":13,"is_corresponding":false},{"id":826513,"name":"Ashley N. Battarbee","orcid":"0000-0002-4837-8059","position":0,"is_corresponding":true}],"reference_count":21,"raw_metadata":null,"created_at":"2026-07-19T00:27:10.233250Z","pmid":"36323337","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}