{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T15:49:45Z","timestamp":1786549785892,"version":"build-2736575974"},"reference-count":40,"publisher":"American Medical Association (AMA)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Gestational diabetes is associated with future cardiometabolic risk, but postpartum evidence across the cardiovascular-kidney-metabolic (CKM) disorder spectrum remains limited.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To characterize the timing and magnitude of incident postpartum CKM disorders after a pregnancy complicated by gestational diabetes.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This retrospective cohort study used data from April 1, 2007, to October 12, 2023, from the Merative MarketScan commercial database. Participants were commercially insured females aged 12 to 55 years with a single delivery and no preexisting CKM disorders before delivery. Follow-up began after delivery and continued until incident diagnosis, disenrollment, or end of data availability. Data were analyzed from August 2025 to March 2026.<\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n Gestational diabetes, identified using diagnosis codes requiring 1 or more inpatient claims or 2 or more outpatient claims during pregnancy.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Incident postpartum diagnoses of obesity, hypertension, hyperlipidemia, prediabetes, type 2 diabetes, metabolic syndrome, chronic kidney disease, and cardiovascular disease. Cox proportional hazards regression models estimated adjusted hazard ratios (AHRs) and 95% CIs. Temporal patterns were assessed using postpartum interval-specific HRs and year-specific incidence rate ratios.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Of 1\u202f153\u202f998 females (mean [SD] age, 28.0 [5.8] years), 95\u202f103 (8.2%) had gestational diabetes; median follow-up was 2.4 years (IQR, 1.6-3.8 years). Compared with individuals without gestational diabetes, those with gestational diabetes had higher crude incidence rates per 1000 person-years of type 2 diabetes (9.9 vs 1.0), prediabetes (12.9 vs 2.5), hyperlipidemia (19.9 vs 10.1), hypertension (13.9 vs 8.1), and obesity (26.3 vs 15.2). In adjusted models, gestational diabetes was associated with dysglycemia, including type 2 diabetes (time-averaged AHR, 10.02; 95% CI, 9.53-10.52) and prediabetes (AHR, 5.32; 95% CI, 5.12-5.53), metabolic syndrome (AHR, 2.72, 95% CI, 2.49-2.98), hyperlipidemia (AHR, 2.00; 95% CI, 1.95-2.06), hypertension (AHR, 1.76; 95% CI, 1.70-1.82), and obesity (AHR, 1.75; 95% CI, 1.71-1.79). Composite cardiovascular disease risk was elevated (AHR, 1.28; 95% CI, 1.18-1.40), whereas chronic kidney disease was not (AHR, 0.96; 95% CI, 0.76-1.22).<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this cohort study, gestational diabetes was associated with increased postpartum risk across multiple metabolic disorders. These findings suggest that postpartum care after gestational diabetes may need to extend beyond glucose monitoring to include broader cardiometabolic risk surveillance.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.28578","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T15:00:27Z","timestamp":1786546827000},"page":"e2628578","source":"Crossref","is-referenced-by-count":0,"title":["Gestational Diabetes and Postpartum Cardiovascular, Kidney, and Metabolic Disorders"],"prefix":"10.1001","volume":"9","author":[{"given":"Lili","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Population Health, Stanford University Medical Center, Palo Alto, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junjie Anderson","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Population Health, Stanford University Medical Center, Palo Alto, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther E.","family":"Velasquez","sequence":"additional","affiliation":[{"name":"Center for Population Health Sciences, Stanford University Medical Center, Palo Alto, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cande V.","family":"Ananth","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Biostatistics, Department of Obstetrics, Gynecology and Reproductive Sciences, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey"},{"name":"Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, New Jersey"},{"name":"Cardiovascular Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mindie H.","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Population Health, Stanford University Medical Center, Palo Alto, California"},{"name":"Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle A.","family":"Williams","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Population Health, Stanford University Medical Center, Palo Alto, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"issue":"9","key":"zoi260775r1","doi-asserted-by":"publisher","first-page":"870","DOI":"10.1001\/jama.2023.14997","article-title":"Gestational diabetes and long-term cardiometabolic health.","volume":"330","author":"Venkatesh","year":"2023","journal-title":"JAMA"},{"issue":"1","key":"zoi260775r2","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1038\/s41572-019-0098-8","article-title":"Gestational diabetes 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