World J Diabetes. 2016 Jun 25;7(12):252-9. doi: 10.4239/wjd.v7.i12.252.
Does parity worsen diabetes-related chronic complications in women with type 1 diabetes?.
World journal of diabetes
Marilia Brito Gomes, Carlos Antonio Negrato, Ana Almeida, Antonio Ponce de Leon
Affiliations
Affiliations
- Marilia Brito Gomes, Ana Almeida, Department of Internal Medicine, Diabetes Unit, State University of Rio de Janeiro, Rio de Janeiro 20550-900, Brazil.
PMID: 27350848
PMCID: PMC4914833 DOI: 10.4239/wjd.v7.i12.252
Abstract
AIM: To determine the relationship between parity, glycemic control, cardiovascular risk factors and diabetes-related chronic complications in women with type 1 diabetes.
METHODS: This was a multicenter cross-sectional study conducted between December 2008 and December 2010 in 28 public clinics in 20 cities from the 4 Brazilian geographic regions. Data were obtained from 1532 female patients, 59.2% Caucasians, and aged 25.2 ± 10.6 years. Diabetes duration was of 11.5 ± 8.2 years. Patient's information was obtained through a questionnaire and a chart review. Parity was stratified in five groups: Group 0 (nulliparous), group 1 (1 pregnancy), group 2 (2 pregnancies), group 3 (3 pregnancies), group 4 (≥ 4 pregnancies). Test for trend and multivariate random intercept logistic and linear regression models were used to evaluate the effect of parity upon glycemic control, cardiovascular risk factors and diabetes-related complications.
RESULTS: Parity was not related with glycemic control and nephropathy. Moreover, the effect of parity upon hypertension, retinopathy and macrovascular disease did not persist after adjustments for demographic and clinical variables in multivariate analysis. For retinopathy, the duration of diabetes and hypertension were the most important independent variables and for macrovascular disease, these variables were age and hypertension. Overweight or obesity was noted in a total of 538 patients (35.1%). A linear association was found between the frequency of overweight or obesity and parity (P = 0.004). Using a random intercept multivariate linear regression model with body mass index (BMI) as dependent variable a borderline effect for parity (P = 0.06) was noted after adjustment for clinical and demographic data. The observed variability of BMI was not attributable to differences between centers.
CONCLUSION: Our results suggest that parity has a borderline effect on body mass index but does not have an important effect upon hypertension and micro or macrovascular chronic complications. Future prospective evaluations must be conducted to clarify the relationship between parity, appearance or worsening of diabetes-related chronic complications.
Keywords: Cardiovascular risk factors; Diabetes-related chronic complications; Glycemic control; Parity; Type 1 diabetes
References
- Clin Chem. 1972 Jun;18(6):499-502 - PubMed
- Acta Obstet Gynecol Scand. 2002 Dec;81(12):1110-5 - PubMed
- Am J Obstet Gynecol. 1988 Jul;159(1):56-66 - PubMed
- Br J Ophthalmol. 1980 Jun;64(6):398-403 - PubMed
- Diabetologia. 2010 May;53(5):809-20 - PubMed
- Diabet Med. 2011 Oct;28(10):1188-93 - PubMed
- J Physiol Pharmacol. 2011 Oct;62(5):567-73 - PubMed
- Growth Horm IGF Res. 2011 Feb;21(1):25-30 - PubMed
- Diabet Med. 2013 Sep;30(9):1087-93 - PubMed
- World Health Organ Tech Rep Ser. 2000;894:i-xii, 1-253 - PubMed
- Acta Endocrinol Suppl (Copenh). 1986;277:122-4 - PubMed
- Diabetes Care. 1995 Jul;18(7):950-4 - PubMed
- Pediatr Diabetes. 2009 Aug;10(5):310-5 - PubMed
- Diabetes Care. 2000 Aug;23(8):1084-91 - PubMed
- Diabet Med. 1995 Jun;12(6):494-9 - PubMed
- J Diabetes Complications. 1998 Mar-Apr;12(2):74-80 - PubMed
- Diabetes Care. 1992 Nov;15(11):1509-16 - PubMed
- Am J Obstet Gynecol. 1996 Apr;174(4):1180-9; discussion 1189-91 - PubMed
- Acta Diabetol. 2013 Oct;50(5):781-7 - PubMed
- BMJ Open. 2012 Feb 14;2(1):e000601 - PubMed
- Diabet Med. 2010 Apr;27(4):431-5 - PubMed
- Diabet Med. 1996 Feb;13(2):165-9 - PubMed
- Br Med J (Clin Res Ed). 1985 Mar 16;290(6471):811-5 - PubMed
- Clin Obstet Gynecol. 1991 Sep;34(3):516-25 - PubMed
- Diabetes Res Clin Pract. 2012 Jul;97(1):63-70 - PubMed
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