Risks of gestational diabetes and preeclampsia over the last decade in a cohort of Alberta women.
OBJECTIVE
The incidence of gestational diabetes mellitus (GDM) is increasing. However, less is known about the incidence of preeclampsia (PE) and whether it is affected by the presence of GDM. We sought to document the population-level incidence of GDM and PE during the last decade and examine the association between GDM and PE after accounting for established risk factors.


METHODS
We selected a population-based cohort retrospectively using data from the Alberta Perinatal Health Program registry. Logistic regression was used to examine the association between GDM and PE after adjusting for baseline characteristics.


RESULTS
Of 426 296 deliveries between 2000 and 2009, 422 672 were in women without pre-existing diabetes. Among these women, the incidence of GDM increased from 3.1% in 2000 to 4.6% in 2009 (P < 0.01), while the incidence of PE remained stable at approximately 1.3% per year. The incidence of PE was significantly higher in women with GDM than in those without GDM (2.6% vs. 1.2%; P < 0.01). After adjustment, women with GDM had a 90% higher risk of PE than those without GDM (OR 1.9; 95% CI 1.7 to 2.1). Other significant risk factors for PE were age, obesity, nulliparity, multifetal gestation, pre-existing hypertension, and chronic kidney disease.


CONCLUSIONS
In this contemporary population-based study spanning 10 years, there was a significant increase in the incidence of GDM over time. The higher incidence of PE in women with GDM than in normoglycemic women suggests a need for heightened surveillance and monitoring of women with GDM for the development of PE.
Faculty of Medicine, University of Alberta, Edmonton AB; Faculty of Medicine, University of Ottawa, Ottawa ON.
Kara A
KA
Nerenberg
School of Public Health, University of Alberta, Edmonton AB.
Jeffrey A
JA
Johnson
Canadian VIGOUR Centre, University of Alberta, Edmonton AB.
Becky
B
Leung
Canadian VIGOUR Centre, University of Alberta, Edmonton AB.
Anamaria
A
Savu
Faculty of Medicine, University of Alberta, Edmonton AB.
Edmond A
EA
Ryan
Faculty of Medicine, University of Alberta, Edmonton AB.
Constance L
CL
Chik
Faculty of Medicine, University of Alberta, Edmonton AB; School of Public Health, University of Alberta, Edmonton AB; Canadian VIGOUR Centre, University of Alberta, Edmonton AB; Mazankowski Alberta Heart Institute, University of Alberta, Edmonton AB.
Padma
P
Kaul
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000416:Alberta / Q000453:epidemiology; D016640:Diabetes, Gestational / Q000453:epidemiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D015994:Incidence; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D010298:Parity; D011225:Pre-Eclampsia / Q000453:epidemiology*; D011247:Pregnancy; D011272:Pregnancy, Multiple; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
diabetes mellitus; epidemiology; gestational diabetes; preeclampsia; pregnancy