Long-term risk of all-cause mortality and cardiovascular events in women with gestational diabetes mellitus: a systematic review and meta-analysis

TL;DR

Women with gestational diabetes mellitus face higher long-term risks of death and cardiovascular events compared to those without it.

Contribution

This study provides a comprehensive meta-analysis of long-term cardiovascular risks associated with gestational diabetes.

Findings

Women with GDM had a 29% higher risk of all-cause mortality.

GDM was linked to increased risks of heart failure, myocardial infarction, and ischemic stroke.

The absolute mortality rate was higher in the GDM group (3.2% vs. 2.5%).

Abstract

This meta-analysis investigates the long-term association between gestational diabetes mellitus (GDM) and the risks of all-cause mortality and specific cardiovascular events in women.

We analyzed 9 high-quality cohort studies involving 4,191,840 women (age range: 24.5-34.6 years).

Compared to women without GDM, those with a history of GDM had significantly increased risks of: All-cause mortality (HR = 1.29, 95% CI 1.09-1.52),Acute heart failure (HR = 1.74, 95% CI 1.36-2.23), Myocardial infarction (HR = 1.63, 95% CI 1.38-1.91), Ischemic stroke (HR = 1.70, 95% CI 1.28-2.26). Heterogeneity was observed for all outcomes except myocardial infarction. Sensitivity analyses confirmed the robustness of the findings. The absolute incidence of all-cause mortality was also higher in the GDM group (3.2% vs. 2.5%). No significant publication bias was detected.

GDM is significantly associated with elevated long-term risks of all-cause mortality and cardiovascular morbidity. These findings underscore the necessity for long-term monitoring and preventive strategies in this population, even after postpartum glucose normalization.

https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42025649099.

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