Women who develop gestational diabetes may be at an increased risk of developing early heart disease, a new study suggests.

Gestational diabetes is a type of diabetes that develops during pregnancy - most often in the second or third trimester. It usually disappears after the baby is born, although women who develop it are at an increased risk of developing diabetes later on.

US scientists monitored almost 900 women, aged between 18 and 30, over a 20-year period. At the beginning of the study none of the women had given birth and all were assessed for heart disease risk factors. They all went on to give birth at least once.

Over the next two decades, they were tested for diabetes and metabolic conditions before and after their pregnancies. The thickness of their carotid artery was also measured around 12 years after pregnancy, when the women were aged between 38 and 50.

The thickness of this artery is an early indicator of atherosclerosis (hardening of the arteries) and can predict the risk of heart attack and stroke in women.

The study participants were divided into those who developed gestational diabetes and those who did not. Some 13% of the women developed the condition.

The scientists found that women who had developed gestational diabetes had a thicker carotid artery than women who had not developed the condition. This difference could not be attributed to obesity or high glucose levels before pregnancy.

"This finding indicates that a history of gestational diabetes may influence development of early atherosclerosis before the onset of diabetes and metabolic diseases that previously have been linked to heart disease. Gestational diabetes may be an early risk factor for heart disease in women," said the study's lead author, Dr Erica Gunderson, of Kaiser Permanente Northern California.

She insisted that pregnancy has been ‘under-recognised as an important time period that can signal a woman's greater risk for future heart disease'.

"It's a shift in thinking about how to identify a subgroup at risk for atherosclerosis early. The concept that reproductive complications unmask future disease risk is a more recent focus," she added.
Details of these findings are published in the Journal of the American Heart Association.

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