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However, long\u2010term population\u2010based studies investigating common CVD risk factors years after pregnancy are lacking. To evaluate the future mortality and morbidity in cardiovascular and metabolic diseases, we conducted a thorough investigation of midlife risk factors in women with and without previous GDM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and Methods<\/jats:title><jats:p>A prospective population\u2010based cohort study was conducted of 3173 parous women from the Northern Finland Birth Cohort, 1966. Study participants were obtained from the national register or patient records. Those with a GDM diagnosis formed the GDM cohort (<jats:italic>n<\/jats:italic>\u2009=\u2009271), and those without a previous GDM diagnosis formed the control cohort (<jats:italic>n<\/jats:italic>\u2009=\u20092902). Clinical examinations were performed on participants at the age of 46 and included anthropometric measurements, oral glucose tolerance test (OGTT), biochemical measurements, and cardiovascular assessment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>At the age of 46, women in the GDM cohort had a higher body mass index (BMI, 29.0\u2009kg\/m<jats:sup>2<\/jats:sup> vs 26.3\u2009kg\/m<jats:sup>2<\/jats:sup>, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and greater waist circumference (94.1\u2009cm vs 86.5\u2009cm, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) than the control cohort. In the GDM cohort, a higher incidence of impaired glucose tolerance (12.6% vs 7.3%, <jats:italic>p<\/jats:italic>\u2009=\u20090.002), more previously diagnosed and OGTT\u2010detected type 2 diabetes (23.3% vs 3.9%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), lower high\u2010density lipoprotein (1.53\u2009mmol\/L vs 1.67\u2009mmol\/L, <jats:italic>p<\/jats:italic>\u2009=\u20090.011), higher triglycerides (1.26\u2009mmol\/L vs 1.05\u2009mmol\/L, <jats:italic>p<\/jats:italic>\u2009=\u20090.002) and a higher fatty liver index (6.82 vs 2.47, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), were observed even after adjusting for BMI, polycystic ovary syndrome, parity, level of education, physical activity, smoking, and alcohol consumption. The women in the GDM cohort also had more MetS (42.6% vs 21.9%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and higher risk scores for CVD and fatal events (Framingham 4.95 vs 3.60, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001; FINRISK 1.71 vs 1.08, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Women with a previous diagnosis of GDM exhibit more risk factors for CVD in midlife and are at a higher risk for cardiovascular events later in life.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14861","type":"journal-article","created":{"date-parts":[[2024,5,10]],"date-time":"2024-05-10T05:13:48Z","timestamp":1715318028000},"page":"1318-1328","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Women with a history of gestational diabetes mellitus present an accumulation of cardiovascular risk factors at age 46\u2014A birth cohort 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Population Studies, Faculty of Medicine University of Oulu  Oulu Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5987-7534","authenticated-orcid":false,"given":"Laure","family":"Morin\u2010Papunen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University Hospital of Oulu  Oulu Finland"},{"name":"Research Unit of Clinical Medicine Medical Research Center Oulu, University of Oulu  Oulu Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1218-6925","authenticated-orcid":false,"given":"Sirkka","family":"Kein\u00e4nen\u2010Kiukaanniemi","sequence":"additional","affiliation":[{"name":"Center for Life Course Health Research University of Oulu  Oulu Finland"},{"name":"Healthcare and Social Services of Sel\u00e4nne  Pyh\u00e4j\u00e4rvi 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