ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Clinical Diabetes
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1656498
This article is part of the Research TopicHighlights in Diabetes and PregnancyView all 4 articles
Gestational Diabetes: A Contributor to Long-Term Thyroid Dysfunction and Disease
Provisionally accepted
- Taichung Veterans General Hospital, Taichung, Taiwan
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Background Emerging evidence links gestational diabetes mellitus (GDM) with thyroid dysfunction, but the long-term risk of clinically diagnosed thyroid diseases after GDM remains unclear. Objective To assess the long-term risk of specific thyroid disorders in women with prior GDM compared with those without GDM. Methods We performed a retrospective cohort study using the TriNetX U.S. Collaborative Network, including de-identified records from >80 healthcare organizations. Women aged 16–45 years with pregnancies from 2001 to 2015 were eligible; those with pre-existing hypertension, diabetes, thyroid disease, thyroid surgery, or preeclampsia/eclampsia were excluded. GDM was identified by ICD codes. The primary outcome was first diagnosis of thyroid disorders—hyperthyroidism, hypothyroidism, toxic/non-toxic goiter, thyroiditis (acute, subacute, Hashimoto’s), benign thyroid neoplasms, and thyroid cancer—after the index pregnancy. Propensity score matching (1:1) accounted for age, race, overweight/obesity, nicotine dependence, and alcohol abuse. Follow-up extended up to 20 years. Hazard ratios (HRs) were estimated using Cox models; cumulative incidence was compared with Kaplan–Meier analysis. Results After matching, GDM was associated with higher risks of hyperthyroidism (HR 1.60, 95% CI 1.30–1.99), hypothyroidism (HR 1.33, 95% CI 1.17–1.51), thyroiditis (HR 1.55, 95% CI 1.21–2.00), Hashimoto’s thyroiditis (HR 1.37, 95% CI 1.02–1.83), toxic goiter (HR 1.70, 95% CI 1.19–2.44), and non-toxic goiter (HR 1.26, 95% CI 1.10–1.45). No association was found for benign neoplasms or thyroid cancer. Risks were greater in women aged 35–45 years and those with BMI >25. Conclusion GDM is linked to increased long-term risk of multiple thyroid diseases, warranting extended thyroid monitoring in older and overweight/obese women.
Keywords: gestational diabetes mellitus, Thyroid disease, Thyroid function, Hyperthyroidism - diagnosis, Hypothyroidism
Received: 30 Jun 2025; Accepted: 13 Aug 2025.
Copyright: © 2025 Shih, Hsieh, Wang, Lu and Tseng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jenn-Jhy Tseng, Taichung Veterans General Hospital, Taichung, Taiwan
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