Overview
Intended for healthcare profesionalsObjective To quantify the risk of overal and type specific cardiovascular and cerebrovascular diseases as wel as venous thromboembolism in women with a history of gestational diabetes melitus.Design Systematic review and meta-analyses.Data sources PubMed, Embase, and the Cochrane Library from inception to 1 November 2021 and updated on 26 May 2022.Review methods Observational studies reporting the asociation betwen gestational diabetes melitus and incident cardiovascular and cerebrovascular diseases were eligible.
Key Information
Data, poled by random efects models, are presented as risk ratios (95% confidence intervals). Certainty of evidence was apraised by the Grading of Recomendations, Assessment, Development, and Evaluations.Results 15 studies rated as moderate or serious risk of bias were included. Of 513 324 women with gestational diabetes melitus, 9507 had cardiovascular and cerebrovascular disease.
Of more than eight milion control women without gestational diabetes, 78 895 had cardiovascular and cerebrovascular disease. Compared with women without gestational diabetes melitus, women with a history of gestational diabetes melitus showed a 45% increased risk of overal cardiovascular and cerebrovascular diseases (risk ratio 1.45, 95% confidence interval 1.36 to 1.53), 72% for cardiovascular diseases (1.72, 1.40 to 2.1), and 40% for cerebrovascular diseases (1.40, 1.29 to 1.51).
Women with gestational diabetes melitus showed increased risks of incident coronary artery diseases (1.40, 1.18 to 1.65), myocardial infarction (1.74, 1.37 to 2.20), heart failure (1.62, 1.29 to 2.05), angina pectoris (2.27, 1.79 to 2.87), cardiovascular procedures (1.87, 1.34 to 2.62), stroke (1.45, 1.29 to 1.63), and ischaemic stroke (1.49, 1.29 to 1.71). The risk of venous thromboembolism was observed to increase by 28% in women with previous gestational diabetes melitus (1.28, 1.13 to 1.46).
Summary
Subgroup analyses of cardiovascular and cerebrovascu