Women with preeclampsia and gestational hypertension have a twofold increased risk for developing diabetes when followed up to 16.5 years after pregnancy, according to findings in a Canadian study.
The literature has established that women with preeclampsia and gestational hypertension exhibit insulin resistance during pregnancy, independent of obesity and glucose intolerance. Therefore, researchers conducted a population-based, retrospective cohort study of 1,010,068 pregnant women (aged 15 to 50 years) who gave birth in Ontario, Canada, between April 1994 and March 2008.
The women were categorized as having preeclampsia alone (n=22,933), gestational hypertension alone (n=27,605), gestational diabetes alone (n=30,852), gestational diabetes and preeclampsia (n=1,476), gestational diabetes and gestational hypertension (n=2,100) or none of these conditions (n=925,102).
Based on new records in the Ontario Diabetes Database, researchers reported the outcome of a diabetes diagnosis postpartum in the following years, until March 2011 (16.5 years follow-up).
According to data, the incidence rate for diabetes per 1,000 person-years was 6.47 for women with preeclampsia and 5.26 for women with gestational hypertension vs. 2.81 in women with neither of these conditions. Further data indicate preeclampsia alone (HR=2.08; 95% CI, 1.97-2.19) and gestational hypertension alone (HR=1.95; 95% CI, 1.83-2.07) were risk factors for resulting diabetes.
Moreover, women diagnosed with gestational diabetes alone had a greater risk for developing diabetes postpartum (HR=12.77; 95% CI, 12.44-13.10), researchers wrote. However, the existence of preeclampsia (HR=15.75; 95% CI, 14.52-17.07) or gestational hypertension (HR=18.49; 95% CI, 17.12-19.96) combined with gestational diabetes increased this risk.
The researchers suggest these findings have clinical implications for maternal health.
“A history of [preeclampsia] or [gestational hypertension] during pregnancy should alert clinicians to the need for preventive counseling and more vigilant screening for diabetes,” they wrote.
Disclosure: The researchers report no relevant financial disclosures.