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. 2022 Feb 9;17(2):e0263529.
doi: 10.1371/journal.pone.0263529. eCollection 2022.

Cardiometabolic outcomes of women exposed to hyperglycaemia first detected in pregnancy at 3-6 years post-partum in an urban South African setting

Veronique Nicolaou  1   2 , Larske Soepnel  1   3 , Kenneth Huddle  2 , Kerstin Klipstein-Grobusch  3   4 , Naomi S Levitt  5 , Shane A Norris  1   6
Affiliations

Cardiometabolic outcomes of women exposed to hyperglycaemia first detected in pregnancy at 3-6 years post-partum in an urban South African setting

Veronique Nicolaou et al. PLoS One. .

Erratum in

Abstract

Background: Hyperglycaemia first detected during pregnancy(HFDP) has far-reaching maternal consequences beyond the pregnancy. Our study evaluated the cardiometabolic outcomes in women with prior HFDP versus women without HFDP 3-6 years post-partum in urban South Africa.

Design and methods: A prospective cohort study was performed of 103 black African women with prior HFDP and 101 without HFDP, 3-6 years post-partum at Chris Hani Baragwanath Academic Hospital, Soweto. Index pregnancy data was obtained from medical records. Post-partum, participants were re-evaluated for anthropometric measurements, body composition utilizing dual energy X-ray absorptiometry(DXA) and biochemical analysis (two-hour 75gm OGTT fasting insulin, lipids, creatinine levels and glucose levels). Cardiovascular risk was assessed by Framingham risk score(FRS). Carotid intima media thickness(cIMT) was used as a surrogate marker for subclinical atherosclerosis. Factors associated with progression to cardiometabolic outcomes were assessed using multivariable logistic and linear regression models.

Results: Forty-six(45.1%) HFDP women progressed to diabetes compared to 5(4.9%) in non HFDP group(p<0.001); only 20(43.4%) were aware of their diabetic status in the whole group. The odds(OR, 95% confidence interval(CI)) of progressing to type 2 diabetes(T2DM) and metabolic syndrome(MetS) after correcting for confounders in the HFDP group was 10.5(95% CI 3.7-29.5) and 6.3(95%CI 2.2-18.1), respectively. All visceral fat indices were found to be significantly higher in the HFDP group after adjusting for baseline body mass index. Ten-year estimated cardiovascular risk(FRS) and mean cIMT was statistically higher in the HFDP group(8.46 IQR 4.9-14.4; 0.48 mm IQR 0.44-0.53 respectively) compared to the non-HFDP group(3.48 IQR 2.1-5.7; 0.46mm IQR 0.42-0.50) respectively and this remained significant for FRS but was attenuated for cIMT after correcting for confounders. HIV did not play a role in progression to any of these outcomes.

Conclusion: Women with a history of HFDP have a higher risk of cardiometabolic conditions within 6 years post-partum in an urban sub-Saharan African setting.

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Conflict of interest statement

No. The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow diagram of the study and eligible participants.
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References

    1. Bellamy L, Casas JP, Hingorani AD, Williams D. Type 2 diabetes mellitus after gestational diabetes: a systematic review and meta-analysis. The Lancet [Internet]. 2009. May 23 [cited 2020 Sep 1];373(9677):1773–9. Available from: http://www.thelancet.com/article/S0140673609607315/fulltext. doi: 10.1016/S0140-6736(09)60731-5 - DOI - PubMed
    1. Kramer CK, Campbell S, Retnakaran R. Gestational diabetes and the risk of cardiovascular disease in women: a systematic review and meta-analysis. Diabetologia. 2019;62:905–14. doi: 10.1007/s00125-019-4840-2 - DOI - PubMed
    1. Xu Y, Shen S, Sun L, Yang H, Jin B, Cao X. Metabolic syndrome risk after gestational diabetes: A systematic review and meta-analysis. PLoS ONE. 2014. Jan 31;9(1). doi: 10.1371/journal.pone.0087863 - DOI - PMC - PubMed
    1. Adam S, Rheeder P. Screening for gestational diabetes mellitus in a South African population: Prevalence, comparison of diagnostic criteria and the role of risk factors. South African Medical Journal [Internet]. 2017. May 24 [cited 2018 Feb 9];107(6):523. Available from: http://www.samj.org.za/index.php/samj/article/view/11907. doi: 10.7196/SAMJ.2017.v107i6.12043 - DOI - PubMed
    1. Macaulay S, Ngobeni M, Dunger DB, Norris SA. The prevalence of gestational diabetes mellitus amongst black South African women is a public health concern. Diabetes Research and Clinical Practice [Internet]. 2018. May [cited 2018 Sep 21];139:278–87. Available from: http://www.ncbi.nlm.nih.gov/pubmed/29526682. doi: 10.1016/j.diabres.2018.03.012 - DOI - PubMed

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