{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T21:53:44Z","timestamp":1791237224521,"version":"4.1.0"},"reference-count":39,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100023233","name":"National Institute for Health and Care Research Applied Research Collaboration Oxford and Thames Valley","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100023233","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000273","name":"Diabetes Research and Wellness Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000273","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100013374","name":"NIHR School for Primary Care Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100013374","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000361","name":"Diabetes UK","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000361","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100014013","name":"UK Research and Innovation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100014013","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Gestational diabetes mellitus (GDM) is associated with increased risk of developing type 2 diabetes and cardiovascular disease (CVD). Here we explore whether the associations are mediated by development of type 2 diabetes and other CVD risk factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The Exploring Long\u2010term Outcomes following PrEgnancy affected by GDM (ELOPE\u2010GDM) study is a population\u2010based matched cohort study, containing 43\u2009572 records of women diagnosed with GDM matched with 174\u2009288 records of non\u2010GDM women.<\/jats:p>\n                    <jats:p>We used Cox proportional hazards models to assess the risk of GDM on CVD, ischemic heart disease (IHD) and stroke\/TIA and quantified the proportions of these effects mediated by the progression to type 2 diabetes, hypertension or dyslipidaemia using causal mediation analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were significant associations between GDM and CVD; (adjusted HR 1.58 (95% CI 1.27\u20131.97)), IHD (1.83 (1.35\u20132.49)) and stroke\/TIA (1.43 (1.06\u20131.95)). There were strong associations between GDM and developing type 2 diabetes (OR 13.90 (95% CI 13.19\u201314.51)), hypertension (1.87 (1.781\u20131.92)), dyslipidaemia (1.80 (1.76\u20131.84)) or any of these postpartum mediators (1.67 (1.63\u20131.71)). However, most of the effect of GDM on CVD was not attributed to the overall mediating effects of type 2 diabetes (36% (95% CI 8%\u201364%)), hypertension (15% (5%\u201324%)), dyslipidaemia (37% (18%\u201355%)) or a combination of these conditions (32% (11%\u201353%)) which developed after pregnancy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These findings emphasise the need for comprehensive cardio metabolic screening following a pregnancy affected by GDM.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.70210","type":"journal-article","created":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T09:33:18Z","timestamp":1762335198000},"page":"417-426","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Associations between gestational diabetes and cardiovascular disease largely operate independently of postpartum causal pathways: A population\u2010based cohort study in England"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9301-7458","authenticated-orcid":false,"given":"Nerys M.","family":"Astbury","sequence":"first","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Ripullone","sequence":"additional","affiliation":[{"name":"National Perinatal Epidemiology Unit, Nuffield Department of Population Health University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rema","family":"Ramakrishnan","sequence":"additional","affiliation":[{"name":"National Perinatal Epidemiology Unit, Nuffield Department of Population Health University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9800-5296","authenticated-orcid":false,"given":"Mark","family":"Woodwood","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health, School of Public Health Imperial College London  London UK"},{"name":"The George Institute for Global Health University of New South Wales, Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane E.","family":"Hirst","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health, School of Public Health Imperial College London  London UK"},{"name":"Nuffield Department of Women's &amp; Reproductive Health University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,5]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11892-015-0699-x"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0707943"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2018.5541"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2021-067946"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2011.03541.x"},{"key":"e_1_2_9_7_1","first-page":"74","article-title":"Screening, diagnosis and services for women with gestational diabetes mellitus (GDM) in New Zealand: a technical report from the National GDM Technical Working Party","volume":"121","author":"Simmons D","year":"2008","journal-title":"N Z Med J"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.25.10.1862"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)60731-5"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-016-3927-2"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.4103\/ijmr.IJMR_852_18"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2022-070244"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-020-02492-1"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00125-019-4840-2"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc16-1400"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2017.2790"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc08-0706"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022-3514.51.6.1173"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyt127"},{"key":"e_1_2_9_20_1","unstructured":"NICE guideline. 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