In the Journals

Persistent pregnancy loss may signal type 2 diabetes risk

Pia Egerup
Pia Egerup

Danish women who experienced three or more pregnancy losses were more likely to develop type 2 diabetes compared with women who carried pregnancies to term, according to findings published in Diabetologia.

“We found a strong and consistent association between pregnancy loss and type 2 diabetes that increased with increasing number of losses,” Pia Egerup, MD, a doctoral student in the recurrent pregnancy loss unit at Copenhagen University Hospital, Denmark, told Healio. “The clinical implication is that pregnancy loss is a risk factor for later type 2 diabetes. A follow-up strategy with blood profile monitoring could perhaps be beneficial to women with three or more pregnancy losses, so appropriate actions can be applied.”

Egerup and colleagues analyzed data from 24,774 Danish women born between 1957 and 1997 diagnosed with type 2 diabetes between 1977 and 2017 using Danish registry data. Researchers matched the women by year of birth and education level with 247,740 women without diabetes in the general Danish population, and used conditional logistic regression models to estimate ORs for type 2 diabetes with different numbers of pregnancy losses.

Researchers found that, compared with women who had ever been pregnant but reported no pregnancy losses, those who had ever been pregnant with one, two and at least three pregnancy losses had ORs for developing type 2 diabetes of 1.18 (95% CI, 1.13-1.23), 1.38 (95% CI, 1.27-1.49) and 1.71 (95% CI, 1.53-1.92), respectively.

ORs for type 2 diabetes compared with ever-pregnant women reporting no pregnancy losses
Danish women who experienced three or more pregnancy losses were more likely to develop type 2 diabetes compared with women who carried pregnancies to term.

Women who were never pregnant were 1.56 times more likely to develop type 2 diabetes compared with women with any number of pregnancy losses (95% CI, 1.51-1.61), with results persisting after adjustment for obesity and gestational diabetes.

The researchers noted that a limitation of the study is that not all early pregnancy losses are handled in the hospital, but rather by gynecological practitioners or at home, and therefore not registered.

“However, when matching with a control group the bias is reduced, as the registration procedure is similar in cases and controls,” the researchers wrote.

The findings should be interpreted with caution, as the cohort includes women who have actively decided not to have children, women with chronic diseases and women with unexplained infertility, the researchers wrote.

“Future clinical studies should explore whether the association is a consequence of pregnancy loss or a shared immunological or metabolic mechanism,” Egerup said. – by Regina Schaffer

Disclosures: The Ole Kirks Foundation and the Novo Nordisk Foundation funded this study. The authors report no relevant financial disclosures.

Pia Egerup
Pia Egerup

Danish women who experienced three or more pregnancy losses were more likely to develop type 2 diabetes compared with women who carried pregnancies to term, according to findings published in Diabetologia.

“We found a strong and consistent association between pregnancy loss and type 2 diabetes that increased with increasing number of losses,” Pia Egerup, MD, a doctoral student in the recurrent pregnancy loss unit at Copenhagen University Hospital, Denmark, told Healio. “The clinical implication is that pregnancy loss is a risk factor for later type 2 diabetes. A follow-up strategy with blood profile monitoring could perhaps be beneficial to women with three or more pregnancy losses, so appropriate actions can be applied.”

Egerup and colleagues analyzed data from 24,774 Danish women born between 1957 and 1997 diagnosed with type 2 diabetes between 1977 and 2017 using Danish registry data. Researchers matched the women by year of birth and education level with 247,740 women without diabetes in the general Danish population, and used conditional logistic regression models to estimate ORs for type 2 diabetes with different numbers of pregnancy losses.

Researchers found that, compared with women who had ever been pregnant but reported no pregnancy losses, those who had ever been pregnant with one, two and at least three pregnancy losses had ORs for developing type 2 diabetes of 1.18 (95% CI, 1.13-1.23), 1.38 (95% CI, 1.27-1.49) and 1.71 (95% CI, 1.53-1.92), respectively.

ORs for type 2 diabetes compared with ever-pregnant women reporting no pregnancy losses
Danish women who experienced three or more pregnancy losses were more likely to develop type 2 diabetes compared with women who carried pregnancies to term.

Women who were never pregnant were 1.56 times more likely to develop type 2 diabetes compared with women with any number of pregnancy losses (95% CI, 1.51-1.61), with results persisting after adjustment for obesity and gestational diabetes.

The researchers noted that a limitation of the study is that not all early pregnancy losses are handled in the hospital, but rather by gynecological practitioners or at home, and therefore not registered.

“However, when matching with a control group the bias is reduced, as the registration procedure is similar in cases and controls,” the researchers wrote.

The findings should be interpreted with caution, as the cohort includes women who have actively decided not to have children, women with chronic diseases and women with unexplained infertility, the researchers wrote.

“Future clinical studies should explore whether the association is a consequence of pregnancy loss or a shared immunological or metabolic mechanism,” Egerup said. – by Regina Schaffer

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Disclosures: The Ole Kirks Foundation and the Novo Nordisk Foundation funded this study. The authors report no relevant financial disclosures.