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. 2025 Apr;16(4):735-743.
doi: 10.1111/jdi.14400. Epub 2025 Jan 11.

Advanced maternal age is a risk factor for both early and late gestational diabetes mellitus: The Japan Environment and Children's Study

Kazuma Tagami  1 , Noriyuki Iwama  1   2 , Hirotaka Hamada  1 , Hasumi Tomita  1 , Rie Kudo  1 , Natsumi Kumagai  1 , Hongxin Wang  1 , Seiya Izumi  1 , Zen Watanabe  1 , Mami Ishikuro  3   4 , Taku Obara  3   4 , Hirohito Metoki  5   6 , Yuichiro Miura  7 , Chiharu Ota  7   8 , Takashi Sugiyama  9 , Shinichi Kuriyama  3   4   10 , Takahiro Arima  7 , Nobuo Yaegashi  7 , Masatoshi Saito  1   11 ; Japan Environment and Children's Study Group
Affiliations

Advanced maternal age is a risk factor for both early and late gestational diabetes mellitus: The Japan Environment and Children's Study

Kazuma Tagami et al. J Diabetes Investig. 2025 Apr.

Abstract

Aims: This study investigated the association between maternal age and early and late gestational diabetes mellitus (GDM).

Methods: In total, 72,270 pregnant women were included in this prospective birth cohort study. Associations between maternal age and early GDM (diagnosed at <24 gestational weeks) and late GDM (diagnosed at ≥24 gestational weeks) were evaluated using a multinomial logistic regression model with possible confounding factors. The reference category was maternal age of 30-34.9 years.

Results: Higher maternal age was associated with higher odds of early and late GDM (P-value for trend <0.0001 and <0.0001, respectively). The adjusted odds ratios (aORs) for early GDM with maternal age of 35-39.9 years and ≥40 were 1.399 (95% confidence interval [CI]: 1.134-1.725) and 2.494 (95% CI: 1.828-3.402), respectively. The aORs for late GDM with maternal age of 35-39 years and ≥40 were 1.603 (95% CI: 1.384-1.857) and 2.276 (95% CI: 1.798-2.881), respectively.

Conclusions: Higher maternal age was associated with an increased risk of GDM regardless of when GDM was diagnosed. The association between maternal age and early GDM was similar to that between maternal age and late GDM.

Keywords: Advanced maternal age; Gestational diabetes; Insulin resistance.

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Conflict of interest statement

The authors declare no conflict of interest.

Approval of the research protocol: The JECS protocol was reviewed and approved by the Ministry of the Environment's Institutional Review Board on Epidemiological Studies and the Ethics Committees of all participating institutions (Ethical Approval Number: 100910001).

Informed consent: Written informed consent was obtained from all study participants.

Registry and the registration no. of the study/trial: The JECS protocol was reviewed and approved by the Ministry of the Environment's Institutional Review Board on Epidemiological Studies and the Ethics Committees of all participating institutions (No. 2024‐006, approved on 23 August 2024).

Animal studies: N/A.

Figures

Figure 1
Figure 1
Flowchart of participant selection for the study.
Figure 2
Figure 2
Associations between maternal age with early and late GDM. (a) Early GDM. (b) Late GDM. Model 1: Crude model. Model 2: Adjusted for maternal birth weight, maternal height, pre‐pregnancy BMI, PCOS, history of steroid use before 12 weeks of gestation, conception method, smoking history, alcohol drinking status, blood pressure level at <20 weeks of gestation, highest maternal education level, marital status, SLE and/or APS, history of kidney disease, history of mental disorders, annual income, and locations where Regional Centres exist. APS, antiphospholipid antibody syndrome ; BMI, body mass index; CI, confidence interval; GDM, gestational diabetes mellitus; MBW, maternal birth weight; NA, not applicable; OR, odds ratio; PCOS, polycystic ovarian syndrome; SLE, systemic lupus erythematosus.
See this image and copyright information in PMC

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