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Hypertension was associated with risk for gestational diabetes

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High blood pressure before and during early pregnancy was linked to an increased risk for gestational diabetes.

The researchers enrolled women from a case group (n=381) and women from a control group (n=942) who delivered between 1996 and 1998 and who were screened for gestational diabetes between 24 and 28 weeks of gestation.

The American Heart Association BP levels outside of pregnancy were used, according to the researchers. Normal BP was defined as <120 mm Hg/80 mm Hg; prehypertension was defined as 120-139 mm Hg/80-89 mm Hg; and hypertension was defined as ≥140 mm Hg and/or ≥90 mm Hg or use of antihypertensive medications.

Women with prehypertension had an increased risk for gestational diabetes (OR=1.56; 95% CI, 1.16-2.10) during early pregnancy. Women with hypertension had an OR of 2.04 (95% CI, 1.14-3.65) compared with women with normal BP after adjustment.

Women with prehypertension who had BP levels measured before pregnancy had an OR of 1.44 (95% CI, 0.95-2.19), and women with hypertension had an OR of 2.01 (95% CI, 1.01-3.99).

“Clinicians should be aware that women presenting with hypertension may warrant early screening or prevention to prevent gestational diabetes mellitus,” the researchers wrote. – by Christen Haigh

Diabetes Care. 2008;31:2362-2367.

This nested case-control study sought to determine an association between high BP before pregnancy and during the first trimester with an eventual diagnosis of gestational diabetes mellitus during the index pregnancy. American Heart Association criteria were used to identify women with normal blood pressure, prehypertension and hypertension. Women at high risk for gestational diabetes had increased odds of being diagnosed with gestational diabetes. The adjusted odds for gestational diabetes with prehypertension and hypertension were 1.56 and 2.04, respectively.

The association with BP and gestational diabetes likely represents a continuum of the metabolic syndrome. Certainly, blood pressure control during pregnancy continues to be an important factor.

– Alison Semrad, DO
Endocrinology Fellow, UC Davis Medical Center, Sacramento, Calif.

– Lois Jovanovic, MD
Endocrine Today Editorial Board member