V J Roach1, L Y Hin, W H Tam, K B Ng, M S Rogers. 1. Department of Obstetrics and Gynaecology, The Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, NT.
Abstract
OBJECTIVE: To determine the association between pregnancy-induced hypertension (PIH) and carbohydrate intolerance in pregnancy. METHODS: Data on singleton pregnancies were retrieved from the obstetric database of University Hospital, Kuala Lumpur. Gestational impaired glucose tolerance (GIGT) and gestational diabetes mellitus (GDM) were defined according to the World Health Organization criteria. Established diabetes mellitus (EDM) was defined as diabetes mellitus diagnosed prior to pregnancy. PIH was diagnosed according to the criteria of the International Society for the Study of Hypertension in Pregnancy. Maternal characteristics were compared between groups using analysis of variance (ANOVA) and incidence counts using the chi-squared test. Logistic regression analysis using the presence of PIH as the response variable was used to study the association among GDM, GIGT, EDM, and PIH, controlling for maternal factors. MAIN OUTCOME MEASURES: To determine the incidence of PIH among patients with glucose intolerance and the independent risk factors for the development of PIH. RESULTS: There were 24,290 singleton pregnancies retrieved from the database. Both the prevalence of carbohydrate intolerance and the incidence of PIH differed among the three principal ethnic groups (p < 0.0001). There was a significant association between PIH and both a higher maternal age (OR = 1.04, p < 0.0001) and a higher maternal body mass index (BMI) at delivery (OR = 1.14 per unit increment, p < 0.0001). After adjusting for maternal age, BMI, parity, and ethnic origin, using logistic regression, there was a significant residual risk of PIH among individuals with GIGT, GDM, or EDM. CONCLUSIONS: Patients with carbohydrate intolerance of varying severity are at increased risk of developing PIH. Our findings lend credence to the theory that carbohydrate intolerance and PIH share a common etiology.
OBJECTIVE: To determine the association between pregnancy-induced hypertension (PIH) and carbohydrate intolerance in pregnancy. METHODS: Data on singleton pregnancies were retrieved from the obstetric database of University Hospital, Kuala Lumpur. Gestational impaired glucose tolerance (GIGT) and gestational diabetes mellitus (GDM) were defined according to the World Health Organization criteria. Established diabetes mellitus (EDM) was defined as diabetes mellitus diagnosed prior to pregnancy. PIH was diagnosed according to the criteria of the International Society for the Study of Hypertension in Pregnancy. Maternal characteristics were compared between groups using analysis of variance (ANOVA) and incidence counts using the chi-squared test. Logistic regression analysis using the presence of PIH as the response variable was used to study the association among GDM, GIGT, EDM, and PIH, controlling for maternal factors. MAIN OUTCOME MEASURES: To determine the incidence of PIH among patients with glucose intolerance and the independent risk factors for the development of PIH. RESULTS: There were 24,290 singleton pregnancies retrieved from the database. Both the prevalence of carbohydrate intolerance and the incidence of PIH differed among the three principal ethnic groups (p < 0.0001). There was a significant association between PIH and both a higher maternal age (OR = 1.04, p < 0.0001) and a higher maternal body mass index (BMI) at delivery (OR = 1.14 per unit increment, p < 0.0001). After adjusting for maternal age, BMI, parity, and ethnic origin, using logistic regression, there was a significant residual risk of PIH among individuals with GIGT, GDM, or EDM. CONCLUSIONS:Patients with carbohydrate intolerance of varying severity are at increased risk of developing PIH. Our findings lend credence to the theory that carbohydrate intolerance and PIH share a common etiology.