Stroke risk higher in Black women with history of gestational diabetes
The risk of stroke in Black women with gestational diabetes appeared to be driven by type 2 diabetes cases, as those with both diagnoses had a 2.6-fold increased stroke risk versus those who had neither condition, while those with only gestational diabetes had no increase in stroke risk, a U.S. study found.
A history of gestational diabetes is associated with increased stroke risk among Black women, a recent study found.
Researchers used data from the Black Women's Health Study to assess the association between self-reported history of gestational diabetes and incident stroke. Black women who had given birth to a child and had no cerebral vascular disease or cancer were followed until incident stroke, death, or the end of 2021. Incident stroke was the primary outcome. The study results were published May 1 by Stroke.
Overall, 1,495 incident stroke cases were identified among 41,143 Black women from 1995 until 2021, or 881,505 person-years of follow-up. Black women with a history of gestational diabetes had a consistent 1.4-fold increased risk of stroke versus those who had a healthy pregnancy (age-adjusted hazard ratio [HR], 1.44 [95% CI, 1.14 to 1.82]; multivariable HR, 1.41 [95% CI, 1.11 to 1.79]). When compared with parous women who had no history of gestational diabetes or type 2 diabetes, women who had both had a 2.6-fold increased risk for stroke (multivariable HR, 2.59; 95% CI, 1.88 to 3.57). Those who had only type 2 diabetes had a twofold increased risk (multivariable HR, 2.04; 95% CI, 1.79 to 2.32), and those who had a history of gestational diabetes alone had no increased risk (multivariable HR, 1.22; 95% CI, 0.86 to 1.73).
The researchers noted that gestational diabetes was self-reported and that detailed information on certain variables, such as hypertensive disorders of pregnancy, was not available, among other limitations. They concluded that in their large prospective study of Black women, a history of gestational diabetes increased stroke incidence by 41%, with no elevated risk for those with gestational diabetes alone and a 2.6-fold increased risk for those with gestational diabetes and progression to type 2 diabetes. “Our results highlight the importance of consideration of history of [gestational diabetes] for stroke early prevention, especially for Black women with progression to type 2 diabetes after [gestational diabetes],” the authors wrote.