Early first menstrual period is bound to the pregnancy diabetes risk

A pregnant woman gets her blood sugar checked.


Women who have their first period at age 11 or earlier have a higher risk of developing diabetes during pregnancy, a recent Australian study suggests.

Obesity is known to be a factor in the beginning of the period and also in what is known as gestational diabetes, but it does not completely explain the link between the two conditions, the researchers write in the American Journal of Epidemiology.

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Diabetes develops in up to 9 percent of the pregnant women in the United States and can lead to serious health risks, according to the Centers for Disease Control and Prevention.

Mothers with gestational diabetes are more likely to have high blood pressure and go into premature labor, said lead study author Danielle Schoenaker, a research officer at The University of Queensland.

“There are also consequences for the baby, that is more likely to grow faster and larger at birth,” Schoenaker, told Reuters Health by e-mail. “In the long term, both for the mothers and their children have a higher risk of developing type 2 diabetes later in life.”

To explore the relationship between women’s age at first menstruation, known as menarche, and their risk of developing gestational diabetes, the research team analyzed data on nearly 5,000 women participating in the larger Australian Longitudinal Study on Women’s Health between 2000 and 2012.

The women included in the analysis, the reporting of a live-born child during the study and had completed a questionnaire every three to four years, answering questions about when they have their first period and whether they were diagnosed or treated for diabetes during the pregnancy. No one had type 2 diabetes or a personal history of gestational diabetes at the start of the study.

The average age at which women have their first period was just under 13 years, the researchers found.

Women who have their first period at or before the age of 11 years were more likely to have been overweight in childhood, to engage in little physical activity as adults and are currently overweight or obese.

Overall, 357 women, or about 7.5 percent of the participants reported to be diagnosed with gestational diabetes. These women were also more likely to be overweight and a sedentary lifestyle at the beginning of the study.

Women who have their first period before the age of 11 years were 51 percent more likely to develop gestational diabetes, compared with those who started to menstruate at the age of 13.

This was true even after the researchers took into account things that might influence the age at the first menstrual period, or for the risk of gestational diabetes, including maternal educational level, physical activity, previous children, a hormonal disorder known as polycystic ovary syndrome, and the body mass index (BMI), a measurement of body fat based on height and weight.

“Chronic disease risks, such as the risk of type 2 or gestational diabetes can be ‘programmed’ much earlier in life the exposure occurs during mentally sensitive periods, such as puberty, childhood or even intrauterine life,” said Dr. Dana Dabelea, a professor at the University of Colorado Denver who studies gestational diabetes, but was not involved in this research.

Interventions for these health problems may need to start earlier to reduce the risk of diseases, such as diabetes, Dabelea said, per e-mail.

“Women with an early menarche have an increased risk of diabetes later in life, so they need to take additional precautions, in particular, an active lifestyle and maintaining a healthy body weight to reduce, this increased risk,” Dabelea said.

“The support of a healthy environment and behavior early in life are important strategies, and the promotion of healthy diets and physical activity should be a priority for young mothers and schools, and for all the women in their lives,” Schoenaker said.

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