Among women who have not developed diabetes or metabolic syndrome, a history of gestational diabetes mellitus (GDM) may be a marker for early atherosclerosis, according to research published online ahead of print in the Journal of the American Heart Association.

Erica P. Gunderson, PhD, MPH, of Kaiser Permanente Northern California in Oakland, and colleagues followed 898 women (47% black; 18 to 30 years old) who were free of diabetes mellitus and heart disease at baseline and delivered at least one child after baseline. The authors examined the association between GDM and risk of atherosclerosis, measured as common carotid intima media thickness (ccIMT), after 20 years of follow-up.

Among 777 women without subsequent diabetes mellitus or metabolic syndrome, mean ccIMT was a 0.023 mm greater in the GDM group versus the non-GDM group (0.784 vs. 0.761 mm) after controlling for age, race, pre-pregnancy body mass index, and parity. Among 121 women who developed diabetes mellitus or metabolic syndrome, mean ccIMT did not differ between the GDM and non-GDM groups.

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“Our findings support the addition of postpartum screening for cardiovascular disease risk factors among women with a history of GDM, to identify women at highest risk for early cardiovascular disease and related morbidity or mortality during mid-life,” the authors wrote.