Post-Menopause Diabetes Risk and Age at First Pregnancy

Can age at first pregnancy increase your risk of developing diabetes?…

Researchers investigated whether there was any correlation between the age of a woman when she first gave birth to a child and her likelihood of developing post-menopausal diabetes. They used data from 4,965 postmenopausal women of the 37,753 participants from the Korean National Health and Nutrition Examination Survey (KNHANES) which was conducted between 2008 and 2011. Age at first childbirth quartiles (≤ 19 years, 20-24 years, 25-29 years, and ≥ 30 years) were assessed to determine if there was any association between the age and post-menopausal glucose tolerance. Multivariate logistic regressions were completed to assess correlation and to adjust for confounding factors.

Of the 4,956 participants, 21.8% (n=1066) and 15.3% (n=774) had impaired fasting glucose or diabetes, respectively. When stratified by age group, there was a difference in incidence of diabetes rates; 10.9% in ≥ 30 years group and 23.8% in ≤ 19 years old group. And even after adjusting for potential confounding factors such as lifestyle, sociodemographic factors, known diabetes risk factors, and reproductive factors; the < 19 year old group was significantly associated with diabetes development (OR: 1.492 (95% CI 1.005-2.215)). There was no correlation between impaired fasting glucose and age at first childbirth noted in this study.

This study shows that there may be an association between age at first childbirth and development of diabetes in the post-menopausal period. The only age that showed a statically significant correlation was in the < 19 year old group. While the study attempted to control for confounding factors, it is very hard to assess all habits of persons from the age of <19 to post menopause to determine if the early child birth alone put them at increased risk. However, the study does show a fairly significant difference between the <19 and >30 age groups in post-menopausal diabetes rates which may be a useful tool when screening patients who are at higher risk for developing diabetes.

Practice Pearls:

• Age at first childbirth, specifically age < 19 years old, may be associated with increased risk of developing diabetes in the post-menopause period.
• Interestingly, age at first childbirth <20 years old has been associated with approximately half the risk of developing breast cancer as compared to those who have their first child after the age of 30.

Kim, J. et al. Impact of Age at First Childbirth on Glucose Tolerance Status in Postmenopausal Women: The 2008-2011 Korean National Health and Nutrition Examination Survey. Diabetes Care November 15, 2013, published online ahead of print.