title: Pregnancy-Associated Hypertension in Glucose-Intolerant Pregnancy and Subsequent Metabolic Syndrome.
abstract: OBJECTIVE
  To evaluate whether pregnancy-associated hypertension (preeclampsia or gestational hypertension) among women with varying degrees of glucose intolerance during pregnancy is associated with maternal metabolic syndrome 5-10 years later.
  
  
  METHODS
  This was an observational cohort study of women previously enrolled in a treatment trial of mild gestational diabetes mellitus or an observational study of lesser degrees of glucose intolerance evaluated 5-10 years after their index pregnancy. At follow-up, women underwent anthropometric and blood pressure measurements and analysis of fasting glucose and serum lipids.
  
  
  RESULTS
  A total of 825 women (47% of eligible women from the original study) were included in this analysis and evaluated at a median 7 years after their index pregnancy at a median age of 35 years. Overall, 239 (29%) had subsequent metabolic syndrome. The frequency of metabolic syndrome and its components was highest in the women who had pregnancy-associated hypertension and delivered preterm. After adjusting for confounding factors, pregnancy-associated hypertension in women who delivered preterm was associated with subsequent hypertension (130/85 mm Hg or greater; relative risk 3.06, 95% confidence interval [CI] 1.95-4.80, P<.001), high triglycerides (150 mg/dL or greater; relative risk 1.82, 95% CI 1.06-3.14, P=.03), and metabolic syndrome (per the American Heart Association and National Heart Lung and Blood Institute Scientific Statement; relative risk 1.78, 95% CI 1.14-2.78, P=.01) compared with women who remained normotensive throughout their index pregnancy and were delivered at term.
  
  
  CONCLUSIONS
  Women with varying degrees of glucose intolerance who experienced pregnancy-associated hypertension and then delivered preterm had a higher frequency of subsequent hypertension, high triglycerides, and metabolic syndrome 5-10 years later.
authors.affiliation: George Washington University Biostatistics Center, Washington, DC; the Departments of Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio, the University of Utah Health Sciences Center, Salt Lake City, Utah, the University of Texas Southwestern Medical Center, Dallas, Texas, Columbia University, New York, New York, Brown University, Providence, Rhode Island, the University of Alabama at Birmingham, Birmingham, Alabama, the University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, MetroHealth Medical Center-Case Western Reserve University, Cleveland, Ohio, the University of Texas Medical Branch, Galveston, Texas, Northwestern University, Chicago, Illinois, the University of Texas Health Science Center at Houston-Children's Memorial Hermann Hospital, Houston, Texas, and the Medical University of South Carolina, Charleston, South Carolina; and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.
authors.forename: Madeline Murguia
authors.initials: MM
authors.lastname: Rice
authors.forename: Mark B
authors.initials: MB
authors.lastname: Landon
authors.forename: Michael W
authors.initials: MW
authors.lastname: Varner
authors.forename: Brian M
authors.initials: BM
authors.lastname: Casey
authors.forename: Uma M
authors.initials: UM
authors.lastname: Reddy
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: Wapner
authors.forename: Dwight J
authors.initials: DJ
authors.lastname: Rouse
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Biggio
authors.forename: John M
authors.initials: JM
authors.lastname: Thorp
authors.forename: Edward K
authors.initials: EK
authors.lastname: Chien
authors.forename: George
authors.initials: G
authors.lastname: Saade
authors.forename: Alan M
authors.initials: AM
authors.lastname: Peaceman
authors.forename: Sean C
authors.initials: SC
authors.lastname: Blackwell
authors.forename: J Peter
authors.initials: JP
authors.lastname: VanDorsten
mesh_terms: D000328:Adult; D000886:Anthropometry; D001786:Blood Glucose / Q000378:metabolism*; D001794:Blood Pressure; D015331:Cohort Studies; D016640:Diabetes, Gestational / Q000097:blood; D005215:Fasting / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D018149:Glucose Intolerance / Q000097:blood / Q000150:complications*; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000097:blood*; D008055:Lipids / Q000097:blood; D024821:Metabolic Syndrome / Q000209:etiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood*; D047928:Premature Birth / Q000097:blood; D012307:Risk Factors; D047929:Term Birth / Q000097:blood; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D008055:Lipids