History of spontaneous miscarriage and the risk of diabetes mellitus among middle-aged and older Chinese women
Epidemiological studies of the long-term maternal health outcomes of spontaneous miscarriages have been sparse and inconsistent. The objective of our study is to examine the association between spontaneous miscarriages and diabetes among middle-aged and older Chinese women.
A total of 19,539 women from the Dongfeng–Tongji cohort study who completed a questionnaire and had medical examinations performed on were included in the analysis. History of spontaneous miscarriage was obtained by self-reporting in the first follow-up questionnaire interview. The presence of diabetes was determined by a fasting plasma glucose level, self-reported physician diagnosis and use of antidiabetic medication. A series of multivariate logistic regression models were used to calculate the odds ratios and 95% CI across spontaneous miscarriage categories (0, 1, 2, ≥ 3) after adjustment for potential confounding factors.
The prevalence rate of diabetes was 18.8% among the participants. In the fully adjusted logistic regression model, women who had 1, 2 or ≥ 3 spontaneous miscarriages had 0.86 times (95% CI 0.68, 1.08), 1.30 times (95% CI 0.82, 2.04) and 2.11 times (95% CI 1.08, 4.11) higher risk of diabetes, respectively, compared with women who had no history of spontaneous miscarriage.
There is an increased risk of diabetes among women with a history of a higher number of spontaneous miscarriages. History of multiple spontaneous miscarriages should be taken into consideration when assessing the risk of diabetes.
KeywordsDiabetes Epidemiology Pregnancy Spontaneous miscarriage
We thank all staffs of the Health Examination Center of the Dongfeng Central Hospital and the Medical Insurance Center of DMC.
Y.W. and B.L. conceived and designed the study. L.S., X.Z., S.Y., J.Y. and H.L. assisted with study design. B.L. contributed to statistical analysis and wrote the manuscript. L.S. provided statistical advice and assisted with data analysis. Y.W. and Y.L. reviewed and edited the manuscript.
This research was supported by a supporting grant from National Natural Science Foundation of China (Project No. 81273083), Fundamental Research Funds for the Central Universities (2014TS051) and the Hubei Province Health & Family Planning Scientific Research Project (WJ2015MA026).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study was approved by the Medical Ethics Committee of School of Public Health, Tongji Medical School.
Signed informed consent was obtained from all participants included in this study.