Postpartum Body Weight and Cardiometabolic Biomarker Trajectories in Women With Gestational Diabetes: A Population‐Based Matched Cohort Study

ABSTRACT Aims To compare postpartum trajectories in body weight and cardiometabolic biomarkers between women with and without GDM, and to explore the moderating effect of progression to type 2 diabetes (T2DM). Materials and Methods We used electronic primary care healthcare records and linked hospital episode records of women who gave birth between 2001 and 2021. Each woman with GDM was matched to four women without GDM based on age at delivery and delivery date (±3 months). We fitted mixed‐effects multivariate linear models to map biomarker trajectories and extracted coefficients and 95% confidence intervals (CIs) for each year postpartum. Results A total of 43 572 women diagnosed with GDM were matched with 174 288 women without GDM in pregnancy. Across the 15‐year follow‐up, women with GDM weighed more (difference of 5.5 kg [95% CI: 5.3 to 5.7]), had higher HbA1c concentrations (4.4 mmol/mol [95% CI: 4.3 to 4.5]), systolic and diastolic blood pressure (2.6 mmHg [95% CI: 2.4 to 2.7] and 1.7 mmHg [1.6 to 1.8] higher, respectively), and low‐density lipoprotein cholesterol (0.08 [95% CI: 0.06 to 0.10]). However, biomarkers increased at a slower rate during the follow‐up period among women with GDM, except for HbA1c (increase of 9.3 mmol/mol [95% CI: 8.8 to 9.7] and 2.3 mmol/mol [95% CI: 1.9 to 2.6] in the GDM and non‐GDM groups, respectively). Future Progression to type 2 diabetes moderated biomarker trajectories. Conclusion Differences in biomarker trajectories in the early postpartum present an opportunity for early risk stratification and targeted prevention among women with previous GDM.