Identifying the Ongoing Risk and the Critical Time Point of Cardiovascular Diseases in Women With Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis of Cohort Studies

Abstract

This study assessed the risk of cardiovascular diseases (CVD) at various stages in women with gestational diabetes mellitus (GDM) and aimed to identify critical time points when the risk increases. Fifteen cohort studies including a total of 7,515,168 pregnant women were analyzed, among whom 429,564 had GDM and 13,773 developed CVD. Participants were grouped based on follow-up periods of approximately 5, 10, 15, and 25 years. Using random effects models, pooled hazard ratios (HR) with 95% confidence intervals (CI) were calculated. Within five years of diagnosis, women with GDM had a 19% higher risk of CVD (HR 1.19, 95% CI 1.11–1.27) compared to those without GDM, rising to 78% by the tenth year (HR 1.78, 95% CI 1.67–1.89). Long-term follow-up showed risk increases of 31% at 15 years (HR 1.31, 95% CI 1.28–1.35) and 26% at 25 years (HR 1.26, 95% CI 1.16–1.38). Overall, women with GDM had a 35% higher risk of developing CVD than those without (HR 1.35, 95% CI 1.32–1.38). These findings highlight that GDM significantly elevates the risk of cardiovascular diseases, particularly within ten years after diagnosis, emphasizing the need for timely intervention and ongoing monitoring to reduce cardiovascular risk in affected women.