title: Maternal overweight and obesity and risk of pre-eclampsia in women with type 1 diabetes or type 2 diabetes.
abstract: Women with type 1 or type 2 diabetes are at increased risk of pre-eclampsia. Overweight and obesity are associated with an increased risk of pre-eclampsia in women without diabetes. The aim of the study was to investigate the impact of maternal overweight and obesity on the risk of pre-eclampsia in women with type 1 diabetes or type 2 diabetes.
  
  
  
  In a population-based cohort study including singleton births in Sweden, we estimated the risk of pre-eclampsia among women with type 1 diabetes (n = 7062) and type 2 diabetes (n = 886), and investigated whether maternal overweight (BMI 25-29.9 kg/m(2)) and obesity (BMI ≥30.0 kg/m(2)) modified the risk. Logistic regression analyses were used to estimate crude and adjusted ORs with 95% CIs, using women without diabetes as the reference group (n = 1,509,525).
  
  
  
  Compared with women without diabetes, the adjusted ORs for pre-eclampsia in women with type 1 and type 2 diabetes were 5.74 (95% CI 5.31, 6.20) and 2.11 (95% CI 1.65, 2.70), respectively. The corresponding risks of pre-eclampsia combined with preterm birth were even higher. Risks of pre-eclampsia increased with maternal overweight (BMI 25-29.9 kg/m(2)) and obesity (BMI ≥30.0 kg/m(2)), foremost in women without diabetes, to a lesser extent in women with type 1 diabetes but not in women with type 2 diabetes.
  
  
  
  Maternal overweight and obesity increased risks of pre-eclampsia in women with type 1 diabetes but not in women with type 2 diabetes. Even so, considering associations between maternal BMI and overall maternal and offspring risk, all women (with and without diabetes) should aim for a normal weight before pregnancy.
authors.affiliation: Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institutet, Eugeniahemmet T2, 17176, Stockholm, Sweden. Martina.Persson@ki.se.|Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden. Martina.Persson@ki.se.
authors.forename: Martina
authors.initials: M
authors.lastname: Persson
authors.affiliation: Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institutet, Eugeniahemmet T2, 17176, Stockholm, Sweden.
authors.forename: Sven
authors.initials: S
authors.lastname: Cnattingius
authors.affiliation: Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institutet, Eugeniahemmet T2, 17176, Stockholm, Sweden.|Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
authors.forename: Anna-Karin
authors.initials: AK
authors.lastname: Wikström
authors.affiliation: Clinical Epidemiology Unit, Department of Medicine Solna, Karolinska Institutet, Eugeniahemmet T2, 17176, Stockholm, Sweden.|Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Stefan
authors.initials: S
authors.lastname: Johansson
mesh_terms: D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000453:epidemiology; D005260:Female; D006801:Humans; D009765:Obesity / Q000150:complications* / Q000453:epidemiology; D050177:Overweight / Q000150:complications* / Q000453:epidemiology; D011225:Pre-Eclampsia / Q000453:epidemiology / Q000209:etiology*; D011247:Pregnancy; D012307:Risk Factors; D013548:Sweden; D055815:Young Adult
keywords: BMI; Diabetes type 1; Diabetes type 2; Moderate pre-eclampsia; Obesity; Overweight; Pre-eclampsia; Risk of pre-eclampsia; Severe pre-eclampsia