Abstracts Category : Other

Conjoint associations of gestational diabetes, and hypertension with diabetes, hypertension, and cardiovascular disease in parents

by Romina Pace

Diabetes, hypertension and cardiovascular disease (CVD) are leading non-communicable causes of morbidity and mortality worldwide in both women and men. Early preventative strategies targeting lifestyle behaviors can reduce an individual's risk of developing these diseases. In women, pregnancy offers an opportunity to assess cardiometabolic responses and identify those at high risk of post-partum disease based on the occurrence of gestational diabetes (GDM) and/or gestational hypertension (GH) during pregnancy. Despite the rising prevalence of GDM and GH and their demonstrated individual effects, their conjoint effects have not been well studied. This thesis aims to evaluate the relationship of GDM/GH to diabetes, hypertension, and CVD in mothers. Given shared couple behaviours, this thesis also examines these associations in fathers. The main study presented uses a large merged data set that includes health administrative, birth registry, and death registry data on 40,000 triads (mother-father-offspring) with GDM matched to triads without GDM on maternal age, year of delivery and health region. Couples with a history of diabetes, hypertension or CVD were excluded along with their matched triad. Subsequently, mothers were categorized as 'neither' (no GDM and no GH), 'either' (GDM or GH) and 'both' (GDM and GH). Cox regression analysis was then performed to evaluate associations of these categories with diabetes, hypertension, and a composite of CVD and mortality in mothers and in fathers. Graded increased risks across GDM/GH categories were identified for all outcomes in mothers. Smaller but parallel increases operated across these exposure categories for diabetes risk in fathers. These findings signal a need for prevention and surveillance of cardiometabolic disease in both mothers and fathers, particularly those with concurrent GDM and GH during pregnancy in mothers. Le diabte, l'hypertension et les maladies cardiovasculaires (MCV) sont des causes importantes de morbidit et mortalit dans le monde, tant chez l'homme que chez la femme. Des stratgies de prvention ciblant la modification des habitudes de vie peuvent rduire le risque de dvelopper ces maladies. La grossesse devrait saisie comme une opportunit d'valuer les rponses cardio-mtaboliques, ainsi que d'identifier celles ayant un risque lev de maladie cardiovasculaire, notamment, celles ayant eu du diabte gestationnel (DG) et / ou de l'hypertension gestationnelle (HTAG). Malgr leur prvalence croissante, ainsi que leurs consquences bien connues, leurs effets combins n'ont pas t bien tudis. Cette thse vise valuer la relation entre le DG / l'HTAG avec le diabte, l'hypertension et les MCV chez les mres. Compte tenu que les habitudes de vie et comportements sont souvent similaires au sein du couple, cette thse examine galement ces relations chez le pre. L'tude principale utilise un grand ensemble de donnes fusionnes comprenant des donnes administratives de sant, registres des naissances et de dcs sur 40 000 triadesAdvisors/Committee Members: Elham Rahme (Internal/Cosupervisor2), Kaberi Dasgupta (Internal/Supervisor).