Association between gestational diabetes and pregnancy-induced hypertension.
Gestational diabetes and pregnancy-induced hypertension are common, and their relation is not well understood. The authors conducted a population-based case-control study using 1992-1998 Washington State birth certificate and hospital discharge records to investigate this relation. Consecutive cases of pregnancy-induced hypertension were divided into four groups based on International Classification of Diseases, Ninth Revision codes: eclampsia (n=154), severe preeclampsia (n=1,180), mild preeclampsia (n=5,468), and gestational hypertension (n=8,943). Cases were compared with controls who did not have pregnancy-induced hypertension (n=47,237). Gestational diabetes was more common in each case group (3.9% in eclamptics, 4.5% in severe preeclamptics, and 4.4% in both mild preeclamptics and those with gestational hypertension) than in controls (2.7%). After adjustment for body mass index, age, ethnicity, parity, and prenatal care, gestational diabetes was associated with increased risk of severe preeclampsia (odds ratio (OR)=1.5, 95% confidence interval (CI): 1.1, 2.1), mild preeclampsia (OR=1.5, 95% CI: 1.3, 1.8), and gestational hypertension (OR=1.4, 95% CI: 1.2, 1.6). Gestational diabetes was more strongly associated with pregnancy-induced hypertension among women who received less prenatal care (OR=4.2 for eclampsia and OR=3.1 for severe preeclampsia, p<0.05 for both) and among Black women (OR for eclampsia and preeclampsia together=3.9, p<0.05).
Bryson
Chris L
CL
VA Puget Sound Health Services Research and Development, Seattle, WA 98108-1597, USA. cbryson@u.washington.edu
Ioannou
George N
GN
Rulyak
Stephen J
SJ
Critchlow
Cathy
C
D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D016640:Diabetes, Gestational / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D011225:Pre-Eclampsia / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000453:epidemiology* / Q000209:etiology* / Q000503:physiopathology; D014861:Washington / Q000453:epidemiology