Increasing parity a risk factor for diabetes in postmenopausal women?
Having at least four pregnancies through childbearing age appears to increase the risk of diabetes in postmenopausal women without a history of gestational diabetes, a study has found.
Researchers drew data from the continuous National Health and Nutrition Examination Survey 1999–2014 and identified 9,138 postmenopausal women aged ≥40 years who did not develop gestational diabetes ever.
Relative to women with 2–3 pregnancies, those with ≥4 pregnancies had significantly higher fasting plasma glucose (FPG), glycated haemoglobin (HbA1c), 2-hour plasma glucose and the Homeostatic Model Assessment of Insulin Resistance (p<0.01 for all).
Furthermore, significantly more women with greater parity had diabetes (prevalence, 28.4 percent vs 20.7 percent; p<0.001).
Logistic regression analyses revealed that compared with 2–3 pregnancies, having ≥4 pregnancies was associated with an increased likelihood of having elevated levels of FPG and HbA1c (p<0.05 for both).
The adjusted odds ratios for diabetes (vs women with 2–3 pregnancies) were 1.31 (95 percent CI, 1.01–1.71) in women who never got pregnant and 1.28 (1.10–1.48) in those with ≥4 pregnancies.
Potential mechanisms underlying the increased risk of diabetes with each pregnancy involve the influence of multiple pregnancies on postpartum weight retention and the development of obesity as well as the effect of multiple exposures of the metabolic changes of pregnancy on pancreatic function, which lead to long-term increased insulin resistance and decreased β-cell function. [Diabet Med 2017;34:1637-1645]