Gestational diabetes affects a significant number of mothers. It is not yet known what causes the disease, but new research suggests that the age at which a woman experienced her first period may play a role.
During pregnancy, some women who have never had diabetes, or even prediabetes, before develop high blood sugar. This condition is referred to as gestational diabetes (GD), and it starts when the mother’s body cannot produce or use enough insulin to transform the blood sugar into energy.
According to a 2014 report by the Centers for Disease Control and Prevention (CDC), in 2010 GD reportedly affected over 9 percent of women who gave birth that year. The condition usually affects the mother in the late stages of her pregnancy, after the baby has fully developed. For this reason, it does not cause birth defects or other developmental issues in the fetus.
However, untreated GD can increase the levels of blood sugar in the baby, and force the infant to produce more insulin to process the glucose. The result is often fetal macrosomia, or an overweight baby, which may put the newborn at risk of obesity or type 2 diabetes later in life.
It is not yet known what causes GD, but new research – published in the American Journal of Epidemiology – may have found a link between the age at which a woman gets her first period and the risk of developing GD.
The study was conducted by researchers at the University of Queensland School of Public Health in Australia.
The team examined data from more than 4,700 women enrolled in the Australian Longitudinal Study on Women’s Health. Overall, the researchers found that a significantly higher number of women who had had their first period at an earlier age went on to develop diabetes during pregnancy.
Researcher and study co-author Danielle Schoenaker reports that women who had their first period at age 11 or younger had a 50 percent higher risk of developing GD than those who had their first period when they were 13 or older.
The statistical correlation remained strong even after the researchers adjusted for body mass index (BMI) and early life, reproductive, and other lifestyle factors.
Schoenaker comments on the significance of the findings, saying that they “could mean that health professionals will start asking women when they had their first period to identify those at higher risk of gestational diabetes.”
Professor Gita Mishra, director of the Australian Longitudinal Study on Women’s Health, also weighs in: “Research into this topic is of particular public health importance due to global trends of girls starting their menstrual cycles at a younger age,” Prof. Mishra says. She also adds that, apart from GD, precocious puberty in women has also been recently linked to other negative health outcomes.
A review of available research links early puberty in girls with pathologies including insulin resistance, hypothyroidism, a deficiency of growth hormones, and hyperplasia. Obesity also seems prevalent among girls with precocious puberty, and one study found that as much as 81 percent of the girls had additional endocrine problems. Finally, other studies reviewed have linked early puberty to cardiovascular problems such as high blood pressure and higher cholesterol.
Schoenaker also notes the importance of further studies for understanding the reason why early period onset may lead to diabetes during pregnancy.
“A large proportion of women who develop diabetes during pregnancy are overweight or obese, and encouraging those with an early start of puberty to control their weight before pregnancy may help to lower their risk of gestational diabetes. While a healthy weight is important, it is also plausible that the higher risk is explained by hormonal changes, and the research calls for more studies to investigate the mechanisms behind this.”