Background: Pregestational diabetes (PGD) is associated with increased incidence of pregnancy hypertensive disorders (PHD).
Aim: to describe incidence and risk factors for PHD in a retrospective cohort of PGD women.
Methods: Women were evaluated at a specialized prenatal care facility. PHD comprised preeclampsia and gestational hypertension. Gestational weight gain (GWG) was categorized as excessive/non-excessive (2009 IOM); A1C test was measured before the 28th gestational week; most women did not receive prepregnancy counseling.
Results: Of 220 women, 85 were type 1 and 135, type 2 diabetes. Main characteristics (type 1 x type 2) were: age 27.3 (5.7) x 33.5 (5.5) years, p<0.001; self-declared white skin: 88.2% x 76.3%, p=0.044; primigravid: 48.2% x 15.6%, p<0.001; previous PHD: 8.2% x 20.7%, p=0.023; CH: 14.1% x 29.6%, p=0.013; initial A1c test ≥7.0%: 84.3% x 64.3%, p=0.002; excessive GWG: 27.0% x 35.9%, p=0.264. PHD was diagnosed in 64 of 213 women (30%; 95% CI: 24.2-36.5%) and 52 (23.6%; 95% CI 18.4-29.7%) had CH. The Table lists adjusted RR for risk factors.
Conclusion: This PGD cohort showed an increased incidence of PHD, which supports early pregnancy preventive measures, as aspirin. Excessive GWG, a modifiable risk factor, may be prevented through focused prepregnancy and antenatal surveillance.
Table. Risk Factors for Pregnancy Hypertensive Disorders in 213 Women with Pregestational Diabetes.
Risk factor | Relative risk | 95% CI | p |
Type 1 diabetes | 1.77 | 1.11-2.80 | 0.015 |
Self-declared white skin | 3.71 | 1.18-11.68 | 0.025 |
Primigravid | 1.23 | 0.79-1.92 | 0.365 |
Chronic hypertension | 2.10 | 1.38-3.17 | < 0.001 |
Initial A1c test ≥7.0% | 0.70 | 0.46-1.07 | 0.102 |
Excessive GWG | 1.82 | 1.26-2.62 | 0.001 |
Risk factor | Relative risk | 95% CI | p |
Type 1 diabetes | 1.77 | 1.11-2.80 | 0.015 |
Self-declared white skin | 3.71 | 1.18-11.68 | 0.025 |
Primigravid | 1.23 | 0.79-1.92 | 0.365 |
Chronic hypertension | 2.10 | 1.38-3.17 | < 0.001 |
Initial A1c test ≥7.0% | 0.70 | 0.46-1.07 | 0.102 |
Excessive GWG | 1.82 | 1.26-2.62 | 0.001 |
M.R. Oppermann: None. J. Alessi: None. V.N. Hirakata: None. D. Wiegand: None. A.J. Reichelt: None.