Pregnancy induced hypertension in women with gestational carbohydrate intolerance: the diagest study.
OBJECTIVE
To determine the relationship between pregnancy induced hypertension (PIH) and gestational glucose intolerance.


METHODS
A 50g, 1h glucose loading test was offered to all pregnant women between 24 and 28 weeks of gestation in 15 centres in northern France during 8 months in 1992. If the test was positive (> or =7.2 mmol/l), the woman underwent a 3h oral glucose tolerance test (OGTT) as soon as possible. Using the criteria of Carpenter and Coustan, gestational diabetes mellitus (GDM) was defined by two abnormal values (n=218) and gestational mild hyperglycemia (GMH) by one abnormal value (n=130). Each control group was defined by a 50g, 1h loading test result of <7.2 mmol/l (n=108).PIH included gestational hypertension (GH) and preeclampsia (PE). GH was defined as a diastolic pressure of more than 85 mmHg on at least two occasions arising during pregnancy. PE was defined as GH with proteinuria > or =500 mg/24h.


RESULTS
The rate of PIH in the three groups (GDM; GMH and control group, C) was, respectively 17.0, 10.8, and 4.6%. All the six PE occurred in the GDM group. Univariate analysis showed significantly higher rate of hypertension in women with a history of PE, increasing body mass index before pregnancy (BMI) and glucose intolerance. In multivariate analysis with adjustment for primiparity, independent risk factors for PIH were a history of PE, BMI>27 and GDM, contrary to GMH and maternal age.


CONCLUSIONS
PIH appears to be linked to the level of glucose intolerance during pregnancy, independently of other known factors of hypertension.
Vambergue
A
A
Department of Endocrinology and Diabetology, Clinique Marc Linquette, CHRU, 6 Rue du Pr Laguesse, 59800 Lille Cedex, France. a-vambergue@chru-lille.fr
Nuttens
M C
MC
Goeusse
P
P
Biausque
S
S
Lepeut
M
M
Fontaine
P
P
D000328:Adult; D000704:Analysis of Variance; D015992:Body Mass Index; D016640:Diabetes, Gestational / Q000150:complications*; D005260:Female; D005865:Gestational Age; D018149:Glucose Intolerance; D006801:Humans; D006973:Hypertension / Q000150:complications*; D008423:Maternal Age; D010298:Parity; D011225:Pre-Eclampsia / Q000150:complications; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular