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Elevated blood pressure in pregnant women with gestational diabetes according to the WHO criteria: importance of overweight

Item Type:Article
Title:Elevated blood pressure in pregnant women with gestational diabetes according to the WHO criteria: importance of overweight
Creators Name:Birukov, A. and Glintborg, D. and Schulze, M.B. and Jensen, T.K. and Kuxhaus, O. and Andersen, L.B. and Kräker, K. and Polemiti, E. and Jensen, B.L. and Jørgensen, J.S. and Dechend, R. and Andersen, M.S.
Abstract:OBJECTIVE: Hypertension before and during early pregnancy has been associated with an increased risk of gestational diabetes mellitus (GDM) in retrospective analyses. We aimed to investigate the prospective blood pressure trackings in a population-based cohort of pregnant women, who were stratified according to their metabolic status in early third trimester. METHODS: We recorded blood pressure longitudinally during pregnancy in 1230 women from the Odense Child Cohort, Denmark. Fasting glucose and insulin were measured at gestational weeks 28-30. Metabolic status was evaluated according to the WHO 2013 threshold for GDM (GDM-WHO: fasting plasma glucose ≥5.1 mmol/l), insulin and homeostatic model assessment of insulin resistance (HOMA-IR). Relationships between metabolic status in third trimester and blood pressure trajectories were evaluated with adjusted linear mixed models. Trajectory was defined as blood pressure records in pregnancy per 4 weeks interval. RESULTS: Prevalence of GDM-WHO was 40% (498/1230). GDM-WHO was associated with 1.46 (0.22-2.70) mmHg higher SBP and 1.04 (0.07-2.01) mmHg higher DBP trajectories in the overall cohort. The associations were driven by differences in the overweight group, with 3.14 (1.05-5.25) mmHg higher SBP and 1.94 (0.42-3.47) mmHg higher DBP per 4 weeks in women with GDM-WHO compared with women without GDM-WHO. GDM-WHO was not associated with blood pressure in women with normal weight. Blood pressure trajectories were elevated across quartiles of insulin resistance. CONCLUSION: GDM-WHO is associated with higher blood pressure in pregnancy, and there appears to be a stronger effect in overweight women.
Keywords:Blood Pressure, Gestational Diabetes Mellitus, Insulin Resistance, Overweight, Pregnancy, WHO
Source:Journal of Hypertension
Publisher:Lippincott Williams & Wilkins
Page Range:1614-1623
Date:August 2022
Official Publication:https://doi.org/10.1097/HJH.0000000000003196
PubMed:View item in PubMed

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