Associations of maternal preterm birth with subsequent risk for type 2 diabetes in women from the women's health initiative

J Dev Orig Health Dis. 2023 Jun;14(3):333-340. doi: 10.1017/S2040174423000089. Epub 2023 Apr 28.


Preterm birth has been associated with insulin resistance and beta-cell dysfunction, a hallmark characteristic of type 2 diabetes. However, studies investigating the relationship between a personal history of being born preterm and type 2 diabetes are sparse. We sought to investigate the potential association between a personal history of being born preterm and risk for type 2 diabetes in a racially and ethnically diverse population. Baseline and incident data (>16 years of follow-up) from the Women's Health Initiative (n = 85,356) were used to examine the association between personal history of being born preterm (born 1910-1940s) and prevalent (baseline enrollment; cross-sectional) or incident (prospective cohort) cases of type 2 diabetes. Logistic and Cox proportional hazards regression models were used to estimate odds and hazards ratios. Being born preterm was significantly, positively associated with odds for prevalent type 2 diabetes at enrollment (adjOR = 1.79, 95% CI 1.43-2.24; P < 0.0001). Stratified regression models suggested the positive associations at baseline were consistent across race and ethnicity groups. However, being born preterm was not significantly associated with risk for incident type 2 diabetes. Regression models stratified by age at enrollment suggest the relationship between being born preterm and type 2 diabetes persists only among younger age groups. Preterm birth was associated with higher risk of type 2 diabetes but only in those diagnosed with type 2 diabetes prior to study enrollment, suggesting the association between preterm birth and type 2 diabetes may exist at earlier age of diagnosis but wane over time.

Keywords: Preterm birth; developmental origins of adult disease; life course epidemiology; low birth weight; postmenopausal women; type 2 diabetes.

Publication types

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

MeSH terms

  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2* / epidemiology
  • Female
  • Humans
  • Infant, Newborn
  • Premature Birth* / epidemiology
  • Premature Birth* / etiology
  • Prospective Studies
  • Risk Factors
  • Women's Health