Pre-pregnancy menstrual cycle regularity and length and the risk of gestational diabetes mellitus: prospective cohort study,Diabetologia

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Pre-pregnancy menstrual cycle regularity and length and the risk of gestational diabetes mellitus: prospective cohort study
Diabetologia ( IF 8.4 ) Pub Date : 2021-08-14 , DOI: 10.1007/s00125-021-05531-2
Yi-Xin Wang ₁ , Siwen Wang ₁ , Makiko Mitsunami ₁ , JoAnn E Manson _{2,

3} , Janet W Rich-Edwards _{3,

4} , Liang Wang ₅ , Cuilin Zhang ₆ , Jorge E Chavarro _{1,

3,

7}

Affiliation

Aims/hypothesis

Menstrual cycle dysfunction has been associated with many endocrine-related diseases, but evidence linking menstrual cycle dysfunction with gestational diabetes mellitus (GDM) is scant. The current study investigated the association of pre-pregnancy menstrual cycle regularity and length during adolescence, early adulthood and mid-adulthood with the subsequent risk of GDM.

Methods

Between 1993 and 2009, we followed 10,906 premenopausal women participating in the Nurses’ Health Study II who reported menstrual cycle characteristics during adolescence (age 14–17 years), early adulthood (age 18–22 years) and mid-adulthood (age 29–46 years). Incident GDM was ascertained from a self-reported questionnaire regarding physician diagnosis. Log-binomial models with generalised estimating equations were used to estimate the RRs and 95% CI for the associations between menstrual cycle characteristics and GDM.

Results

We documented 578 incident cases of GDM among 14,418 pregnancies over a 16 year follow-up. After adjusting for potential confounders, women reporting always having irregular menstrual cycles during mid-adulthood had a 65% (95% CI 21, 125%) higher risk of GDM than women reporting very regular cycles. GDM risk was also greater among women reporting that their cycles were usually ≥32 days during mid-adulthood, compared with women reporting cycles between 26 and 31 days (RR 1.42 [95% CI 1.15, 1.75]). The risk of GDM was greater for women whose cycles changed from regular early in their reproductive years to irregular or from <32 days to ≥32 days during mid-adulthood, compared with women whose cycles remained <32 days or regular, respectively.

Conclusions/interpretation

Women whose cycles were long or irregular during mid-adulthood, but not in adolescence or young adulthood, were at higher risk of GDM.

Graphical abstract

中文翻译：

孕前月经周期规律和长度以及妊娠期糖尿病的风险：前瞻性队列研究

目标/假设

月经周期功能障碍与许多内分泌相关疾病有关，但将月经周期功能障碍与妊娠糖尿病 (GDM) 联系起来的证据很少。目前的研究调查了青春期、成年早期和成年中期的孕前月经周期规律和长度与随后发生 GDM 的风险之间的关系。

方法

在 1993 年至 2009 年期间，我们跟踪了 10,906 名参加护士健康研究 II 的绝经前妇女，她们报告了青春期（14-17 岁）、成年早期（18-22 岁）和成年中期（29-29 岁）的月经周期特征。 46 岁）。事件 GDM 是从一份关于医生诊断的自我报告问卷中确定的。使用具有广义估计方程的对数二项式模型来估计月经周期特征与 GDM 之间关联的 RR 和 95% CI。

结果

我们在 16 年的随访中记录了 14,418 例妊娠中的 578 例 GDM 事件。在调整了潜在的混杂因素后，报告在成年中期月经周期总是不规律的女性患 GDM 的风险比报告月经周期非常规律的女性高 65% (95% CI 21, 125%)。与报告周期在 26 至 31 天之间的女性相比，报告其周期通常在成年中期≥32 天的女性的 GDM 风险也更高（RR 1.42 [95% CI 1.15, 1.75]）。与周期保持<32天或规律的女性相比，周期从生育早期的规律变为不规律或在成年中期从<32天变为≥32天的女性患GDM的风险更大。