title: Hypertensive disorders in pregnancy and subsequent diabetes mellitus: a retrospective cohort study.
abstract: BACKGROUND
  Cohort study on the association between hypertensive disorders in pregnancy (HDP) and postpartum diabetes is limited. This retrospective cohort study investigated the incidence of diabetes mellitus after delivery among women with HDP using claims data of a universal insurance system.
  
  
  METHODS
  We defined the HDP group as women aged 19-40 years with their first HDP in 2003, excluding those with a history of gestational diabetes mellitus, diabetes mellitus, or hypertension before the date of diagnosis with HDP. Women who had normal pregnancy without HDP were randomly chosen as our comparison group, frequency matched with age and index year of the HDP group. Both groups were followed until December 31, 2008 to evaluate the occurrence of diabetes.
  
  
  RESULTS
  This study consisted of 1139 women with HDP cases and 4527 non-HDP pregnant women. Overall, the subsequent incidence of diabetes mellitus was 5.08-fold higher in the HDP group than in the non-HDP group, with an adjusted hazard ratio of 3.42 (95% confidence interval [CI], 2.07-5.64) after controlling for age, occupation, income, and comorbidity. The hazard ratio of developing diabetes increased to 39.5 (95% CI, 13.0-120.6) for women having HDP, hyperlipidemia, and obesity simultaneously.
  
  
  CONCLUSIONS
  Women with HDP have a high risk of subsequent diabetes. HDP women with obesity and hyperlipidemia are at an extremely high risk of diabetes mellitus. Early identification of women with HDP is needed for prevention, particularly those with other comorbidities.
authors.affiliation: Division of Kidney Disease, College of Medicine, China Medical University and Hospital, Taichung, Taiwan.
authors.forename: I-Kuan
authors.initials: IK
authors.lastname: Wang
authors.forename: I-Ju
authors.initials: IJ
authors.lastname: Tsai
authors.forename: Pei-Chun
authors.initials: PC
authors.lastname: Chen
authors.forename: Chih-Chia
authors.initials: CC
authors.lastname: Liang
authors.forename: Che-Yi
authors.initials: CY
authors.lastname: Chou
authors.forename: Chiz-Tzung
authors.initials: CT
authors.lastname: Chang
authors.forename: Huey-Liang
authors.initials: HL
authors.lastname: Kuo
authors.forename: I-Wen
authors.initials: IW
authors.lastname: Ting
authors.forename: Chung-Chih
authors.initials: CC
authors.lastname: Lin
authors.forename: Feng-Rong
authors.initials: FR
authors.lastname: Chuang
authors.forename: Chiu-Ching
authors.initials: CC
authors.lastname: Huang
authors.forename: Fung-Chang
authors.initials: FC
authors.lastname: Sung
mesh_terms: D000328:Adult; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000503:physiopathology*; D015994:Incidence; D016015:Logistic Models; D011247:Pregnancy; D015995:Prevalence; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology