Sidse Kjærhus Nørgaard1, Marianne Jenlev Vestgaard2, Isabella Lindegaard Jørgensen3, Björg Ásbjörnsdóttir2, Lene Ringholm4, Harold David McIntyre5, Peter Damm6, Elisabeth Reinhardt Mathiesen2. 1. Center for Pregnant Women with Diabetes, Rigshospitalet, Copenhagen, Denmark; Department of Endocrinology, Rigshospitalet, Copenhagen, Denmark. Electronic address: sidse.kjaerhus.noergaard.01@regionh.dk. 2. Center for Pregnant Women with Diabetes, Rigshospitalet, Copenhagen, Denmark; Department of Endocrinology, Rigshospitalet, Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. 3. Center for Pregnant Women with Diabetes, Rigshospitalet, Copenhagen, Denmark; Department of Obstetrics, Rigshospitalet, Copenhagen, Denmark. 4. Steno Diabetes Center Copenhagen, Gentofte, Denmark. 5. Center for Pregnant Women with Diabetes, Rigshospitalet, Copenhagen, Denmark; Mater Clinical School and Mater Research, The University of Queensland, Brisbane, Australia. 6. Center for Pregnant Women with Diabetes, Rigshospitalet, Copenhagen, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Obstetrics, Rigshospitalet, Copenhagen, Denmark.
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.
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.
Authors: Shilong Li; Zichen Wang; Luciana A Vieira; Amanda B Zheutlin; Boshu Ru; Emilio Schadt; Pei Wang; Alan B Copperman; Joanne L Stone; Susan J Gross; Yu-Han Kao; Yan Kwan Lau; Siobhan M Dolan; Eric E Schadt; Li Li Journal: NPJ Digit Med Date: 2022-06-06
Authors: Marianne Vestgaard; Björg Ásbjörnsdóttir; Lene Ringholm; Lise Lotte T Andersen; Dorte M Jensen; Peter Damm; Elisabeth R Mathiesen Journal: Diabetologia Date: 2019-10-18 Impact factor: 10.122
Authors: Julie C Søholm; Marianne Vestgaard; Björg Ásbjörnsdóttir; Nicoline C Do; Berit W Pedersen; Lone Storgaard; Birgitte B Nielsen; Lene Ringholm; Peter Damm; Elisabeth R Mathiesen Journal: Diabetologia Date: 2021-06-19 Impact factor: 10.122