Diastolic blood pressure is a potentially modifiable risk factor for preeclampsia in women with pre-existing diabetes

Sidse Kjærhus Nørgaard; Marianne Jenlev Vestgaard; Isabella Lindegaard Jørgensen; Björg Ásbjörnsdóttir; Lene Ringholm; Harold David McIntyre; Peter Damm; Elisabeth Reinhardt Mathiesen

doi:10.1016/j.diabres.2018.02.014

Diastolic blood pressure is a potentially modifiable risk factor for preeclampsia in women with pre-existing diabetes

Sidse Kjærhus Nørgaard, Marianne Jenlev Vestgaard, Isabella Lindegaard Jørgensen, Björg Ásbjörnsdóttir, Lene Ringholm, Harold David McIntyre, Peter Damm, Elisabeth Reinhardt Mathiesen

Institut for Klinisk Medicin

10 Citationer (Scopus)

Abstract

Aims: To identify early clinical, modifiable risk factors for preeclampsia present at first antenatal visit and assess the prevalence of pregnancy-related hypertensive disorders in women with pre-existing diabetes treated with tight glycemic and blood pressure (BP) control. Methods: A population-based cohort study of 494 women with pre-existing diabetes (307 and 187 women with type 1 and type 2 diabetes, respectively), included at their first antenatal visit from 2012 to 2016. The prevalence of chronic hypertension (without diabetic nephropathy or microalbuminuria), gestational hypertension and preeclampsia was recorded. Diabetic microangiopathy included presence of nephropathy, microalbuminuria and/or retinopathy. Treatment target was BP <135/85 mmHg. Results: HbA1c was 6.9 ± 2.4% (50 ± 12 mmol/mol) at first antenatal visit and 6.0 ± 0.6% (43 ± 6 mmol/mol) before delivery with no differences between women with type 1 and type 2 diabetes. At the first antenatal visit, the prevalence of microalbuminuria was 6% (6% vs. 6%), nephropathy 2% (1% vs. 2%) and chronic hypertension 6% (3% vs. 10%, p = 0.03). Gestational hypertension developed in 8% (9% vs. 6%) and preeclampsia developed in 8% (9% vs. 7%). Presence of diabetic microangiopathy (adjusted odds ratio (OR) 4.35 (confidence interval 2.12–8.93)) and diastolic BP (adjusted OR 1.72 per 10 mmHg (1.05–2.82)) at the first antenatal visit were independent risk factors for preeclampsia. Conclusions: At the first antenatal visit, diastolic BP was the only independent, potentially modifiable risk factor for preeclampsia in women with pre-existing diabetes in the context of tight glycemic and BP control. One out of four women had hypertensive disorders during pregnancy.

Originalsprog	Engelsk
Tidsskrift	Diabetes Research and Clinical Practice
Vol/bind	138
Sider (fra-til)	229-237
Antal sider	9
ISSN	0168-8227
DOI	https://doi.org/10.1016/j.diabres.2018.02.014
Status	Udgivet - apr. 2018

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10.1016/j.diabres.2018.02.014

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Diastolic blood pressure is a potentially modifiable risk factor for preeclampsia in women with pre-existing diabetes. / Nørgaard, Sidse Kjærhus; Vestgaard, Marianne Jenlev; Jørgensen, Isabella Lindegaard et al.
I: Diabetes Research and Clinical Practice, Bind 138, 04.2018, s. 229-237.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

@article{9b0e3c0d727647018dd6e3a4e4f4640f,

title = "Diastolic blood pressure is a potentially modifiable risk factor for preeclampsia in women with pre-existing diabetes",

abstract = "Aims: To identify early clinical, modifiable risk factors for preeclampsia present at first antenatal visit and assess the prevalence of pregnancy-related hypertensive disorders in women with pre-existing diabetes treated with tight glycemic and blood pressure (BP) control. Methods: A population-based cohort study of 494 women with pre-existing diabetes (307 and 187 women with type 1 and type 2 diabetes, respectively), included at their first antenatal visit from 2012 to 2016. The prevalence of chronic hypertension (without diabetic nephropathy or microalbuminuria), gestational hypertension and preeclampsia was recorded. Diabetic microangiopathy included presence of nephropathy, microalbuminuria and/or retinopathy. Treatment target was BP <135/85 mmHg. Results: HbA1c was 6.9 ± 2.4% (50 ± 12 mmol/mol) at first antenatal visit and 6.0 ± 0.6% (43 ± 6 mmol/mol) before delivery with no differences between women with type 1 and type 2 diabetes. At the first antenatal visit, the prevalence of microalbuminuria was 6% (6% vs. 6%), nephropathy 2% (1% vs. 2%) and chronic hypertension 6% (3% vs. 10%, p = 0.03). Gestational hypertension developed in 8% (9% vs. 6%) and preeclampsia developed in 8% (9% vs. 7%). Presence of diabetic microangiopathy (adjusted odds ratio (OR) 4.35 (confidence interval 2.12–8.93)) and diastolic BP (adjusted OR 1.72 per 10 mmHg (1.05–2.82)) at the first antenatal visit were independent risk factors for preeclampsia. Conclusions: At the first antenatal visit, diastolic BP was the only independent, potentially modifiable risk factor for preeclampsia in women with pre-existing diabetes in the context of tight glycemic and BP control. One out of four women had hypertensive disorders during pregnancy.",

keywords = "Adult, Blood Glucose/metabolism, Blood Pressure/physiology, Cohort Studies, Diabetes Complications/complications, Diabetes Mellitus/diagnosis, Female, Humans, Pre-Eclampsia/diagnosis, Pregnancy, Pregnancy in Diabetics/diagnosis, Risk Factors, Young Adult",

author = "N{\o}rgaard, {Sidse Kj{\ae}rhus} and Vestgaard, {Marianne Jenlev} and J{\o}rgensen, {Isabella Lindegaard} and Bj{\"o}rg {\'A}sbj{\"o}rnsd{\'o}ttir and Lene Ringholm and McIntyre, {Harold David} and Peter Damm and Mathiesen, {Elisabeth Reinhardt}",

year = "2018",

month = apr,

doi = "10.1016/j.diabres.2018.02.014",

language = "English",

volume = "138",

pages = "229--237",

journal = "Diabetes Research and Clinical Practice",

issn = "0168-8227",

publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Diastolic blood pressure is a potentially modifiable risk factor for preeclampsia in women with pre-existing diabetes

AU - Nørgaard, Sidse Kjærhus

AU - Vestgaard, Marianne Jenlev

AU - Jørgensen, Isabella Lindegaard

AU - Ásbjörnsdóttir, Björg

AU - Ringholm, Lene

AU - McIntyre, Harold David

AU - Damm, Peter

AU - Mathiesen, Elisabeth Reinhardt

PY - 2018/4

Y1 - 2018/4

N2 - Aims: To identify early clinical, modifiable risk factors for preeclampsia present at first antenatal visit and assess the prevalence of pregnancy-related hypertensive disorders in women with pre-existing diabetes treated with tight glycemic and blood pressure (BP) control. Methods: A population-based cohort study of 494 women with pre-existing diabetes (307 and 187 women with type 1 and type 2 diabetes, respectively), included at their first antenatal visit from 2012 to 2016. The prevalence of chronic hypertension (without diabetic nephropathy or microalbuminuria), gestational hypertension and preeclampsia was recorded. Diabetic microangiopathy included presence of nephropathy, microalbuminuria and/or retinopathy. Treatment target was BP <135/85 mmHg. Results: HbA1c was 6.9 ± 2.4% (50 ± 12 mmol/mol) at first antenatal visit and 6.0 ± 0.6% (43 ± 6 mmol/mol) before delivery with no differences between women with type 1 and type 2 diabetes. At the first antenatal visit, the prevalence of microalbuminuria was 6% (6% vs. 6%), nephropathy 2% (1% vs. 2%) and chronic hypertension 6% (3% vs. 10%, p = 0.03). Gestational hypertension developed in 8% (9% vs. 6%) and preeclampsia developed in 8% (9% vs. 7%). Presence of diabetic microangiopathy (adjusted odds ratio (OR) 4.35 (confidence interval 2.12–8.93)) and diastolic BP (adjusted OR 1.72 per 10 mmHg (1.05–2.82)) at the first antenatal visit were independent risk factors for preeclampsia. Conclusions: At the first antenatal visit, diastolic BP was the only independent, potentially modifiable risk factor for preeclampsia in women with pre-existing diabetes in the context of tight glycemic and BP control. One out of four women had hypertensive disorders during pregnancy.

AB - Aims: To identify early clinical, modifiable risk factors for preeclampsia present at first antenatal visit and assess the prevalence of pregnancy-related hypertensive disorders in women with pre-existing diabetes treated with tight glycemic and blood pressure (BP) control. Methods: A population-based cohort study of 494 women with pre-existing diabetes (307 and 187 women with type 1 and type 2 diabetes, respectively), included at their first antenatal visit from 2012 to 2016. The prevalence of chronic hypertension (without diabetic nephropathy or microalbuminuria), gestational hypertension and preeclampsia was recorded. Diabetic microangiopathy included presence of nephropathy, microalbuminuria and/or retinopathy. Treatment target was BP <135/85 mmHg. Results: HbA1c was 6.9 ± 2.4% (50 ± 12 mmol/mol) at first antenatal visit and 6.0 ± 0.6% (43 ± 6 mmol/mol) before delivery with no differences between women with type 1 and type 2 diabetes. At the first antenatal visit, the prevalence of microalbuminuria was 6% (6% vs. 6%), nephropathy 2% (1% vs. 2%) and chronic hypertension 6% (3% vs. 10%, p = 0.03). Gestational hypertension developed in 8% (9% vs. 6%) and preeclampsia developed in 8% (9% vs. 7%). Presence of diabetic microangiopathy (adjusted odds ratio (OR) 4.35 (confidence interval 2.12–8.93)) and diastolic BP (adjusted OR 1.72 per 10 mmHg (1.05–2.82)) at the first antenatal visit were independent risk factors for preeclampsia. Conclusions: At the first antenatal visit, diastolic BP was the only independent, potentially modifiable risk factor for preeclampsia in women with pre-existing diabetes in the context of tight glycemic and BP control. One out of four women had hypertensive disorders during pregnancy.

KW - Adult

KW - Blood Glucose/metabolism

KW - Blood Pressure/physiology

KW - Cohort Studies

KW - Diabetes Complications/complications

KW - Diabetes Mellitus/diagnosis

KW - Female

KW - Humans

KW - Pre-Eclampsia/diagnosis

KW - Pregnancy

KW - Pregnancy in Diabetics/diagnosis

KW - Risk Factors

KW - Young Adult

U2 - 10.1016/j.diabres.2018.02.014

DO - 10.1016/j.diabres.2018.02.014

M3 - Journal article

C2 - 29475019

SN - 0168-8227

VL - 138

SP - 229

EP - 237

JO - Diabetes Research and Clinical Practice

JF - Diabetes Research and Clinical Practice

ER -

Diastolic blood pressure is a potentially modifiable risk factor for preeclampsia in women with pre-existing diabetes

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