Childbearing is associated with higher incidence of the metabolic syndrome among women of reproductive age controlling for measurements before pregnancy: the CARDIA study

Am J Obstet Gynecol. 2009 Aug;201(2):177.e1-9. doi: 10.1016/j.ajog.2009.03.031. Epub 2009 Jun 26.

Abstract

Objective: We sought to prospectively examine whether childbearing is associated with higher incidence of the metabolic syndrome (MetS) after delivery among women of reproductive age.

Study design: In 1451 nulliparas who were aged 18-30 years and free of the MetS at baseline (1985-1986) and reexamined up to 4 times during 20 years, we ascertained incident MetS defined by the National Cholesterol Education Program Adult Treatment Panel III criteria among time-dependent interim birth groups by gestational diabetes mellitus (GDM): (0 [referent], 1 non-GDM, 2+ non-GDM, 1+ GDM births). Complementary log-log models estimated relative hazards of the MetS among birth groups adjusted for race, age, and baseline and follow-up covariates.

Results: We identified 259 incident MetS cases in 25,246 person-years (10.3/1000 person-years). Compared with 0 births, adjusted relative hazards (95% confidence interval [CI]) were 1.33 (95% CI, 0.93-1.90) for 1 non-GDM, 1.62 (95% CI, 1.16-2.26) for 2+ non-GDM (P trend = .02), and 2.43 (95% CI, 1.53-3.86) for 1+ GDM births.

Conclusion: Increasing parity is associated with future development of the MetS independent of prior obesity and pregnancy-related weight gain. Risk varies by GDM status.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Longitudinal Studies
  • Metabolic Syndrome / epidemiology*
  • Obesity / epidemiology*
  • Parity*
  • Pregnancy
  • Pregnancy Complications / epidemiology*
  • Pregnancy Outcome / epidemiology*
  • Prospective Studies
  • Risk Factors
  • Women's Health
  • Young Adult