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Semin Reprod Med 2009; 27(4): 322-329
DOI: 10.1055/s-0029-1225260
© Thieme Medical Publishers

Late Cardiovascular Consequences of Gestational Diabetes Mellitus

Rhonda Bentley-Lewis1 , 2
  • 1Instructor in Medicine, Harvard Medical School, Boston, Massachusetts
  • 2Associate Physician, Division of Endocrinology, Diabetes, and Hypertension, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts
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Publication History

Publication Date:
15 June 2009 (online)

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ABSTRACT

Gestational diabetes mellitus (GDM), defined as carbohydrate intolerance of any degree first recognized during pregnancy, complicates ~4% of all pregnancies in the United States. Several factors can increase one's risk of developing GDM, including obesity, family history of type 2 diabetes mellitus (T2DM), and race/ethnicity. Conversely, a history of GDM can increase the risk of developing not only T2DM but also cardiovascular disease (CVD) independent of a diagnosis of T2DM. Several investigations have explored GDM relationships with CVD risk factors, CVD surrogate markers, and clinically evident CVD. These studies have included evaluations of biochemical parameters, such as inflammatory and endothelial biomarkers; endothelial dysfunction, such as that seen in impaired brachial artery flow-mediated vasodilation; and vascular dysfunction, manifest as cardiac dysfunction or in diseases such as hypertension. This article will review these studies and examine factors considered to be responsible for promoting CVD in women with a history of GDM, such as T2DM and metabolic syndrome and its components. In addition, studies evidencing CVD in women with a history of GDM will be explored.

KEYWORDS

Gestational diabetes mellitus - cardiovascular disease - endothelial dysfunction - inflammation - biomarkers

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Rhonda Bentley-LewisM.D. M.B.A. M.M.Sc. 

Associate Physician, Brigham and Women's Hospital, Department of Medicine, Division of Endocrinology, Diabetes, and Hypertension

221 Longwood Avenue, Boston, MA 02115

Email: rbentleylewis@partners.org