AIMS: Reproductive factors (parity, miscarriages, terminations), oral contraceptive use, hormone replacement therapy, body weight at first pregnancy and weight gain following pregnancy may be associated with a long-term risk of diabetes. The aim of this study is to investigate the independent risks of reproductive factors and body weight for diabetes in later life. METHODS: This is a retrospective cohort study of 1257 parous women who had a first pregnancy between 1951 and 1970. Reproductive history, weight and height were measured at the time of first pregnancy, then assessed by questionnaire in 1997 for all women. A clinical examination and an analysis of blood samples were undertaken for 992 women. The main outcome was incidence of diabetes based on medical history, medication and random glucose measurement. RESULTS: Sixty of the 1257 (4.8%) women developed diabetes. Body mass index at index pregnancy and after 28-48 years follow-up were both significantly associated with risk of diabetes, this increased with greater weight gain. There was a non-significant increased risk of diabetes associated with stillbirths and miscarriages after age and BMI adjustment. CONCLUSIONS: In parous women, higher BMI at index pregnancy, weight gain during follow-up and BMI in later life strongly predict diabetes risk.
Bibliographical noteThis work was supported by a grant from the British Heart Foundation, and by a PhD studentship (SID)from the University of Aberdeen.We would like to acknowledge the contribution of the following people: Sarah Sunderland for conducting the clinical examinations, Dean Phillips for tracing and data management, Amanda Cardy for review of the original case notes, Nicola Torrance for assistance with the data collection and the operation of clinics, Linda Harrigan and Wendy Aiken for entering the data, Tracy Mapp for assistance with the study design, Isobel Ford and Ian Ross at Department of Medicine, Aberdeen for assistance with the laboratory analysis, and Val Angus of Practitioner Services at Grampian Health Board for the tracing of subjects.
- body weight
- weight gain