title: Hypertensive disorders during pregnancy and risk of type 2 diabetes in later life: a systematic review and meta-analysis.
abstract: Many studies assessed the association between hypertensive disorders during pregnancy and risk of type 2 diabetes mellitus in later life, but contradictory findings were reported. A systemic review and meta-analysis was carried out to elucidate type 2 diabetes mellitus risk in women with hypertensive disorders during pregnancy. Pubmed, Embase, and Web of Science were searched for cohort or case-control studies on the association between hypertensive disorders during pregnancy and subsequent type 2 diabetes mellitus. Random-effect model was used to pool risk estimates. Bayesian meta-analysis was carried out to further estimate the type 2 diabetes mellitus risk associated with hypertensive disorders during pregnancy. Seventeen cohort or prospective matched case-control studies were finally included. Those 17 studies involved 2,984,634 women and 46,732 type 2 diabetes mellitus cases. Overall, hypertensive disorders during pregnancy were significantly correlated with type 2 diabetes mellitus risk (relative risk = 1.56, 95 % confidence interval 1.21-2.01, P = 0.001). Preeclampsia was significantly and independently correlated with type 2 diabetes mellitus risk (relative risk = 2.25, 95 % confidence interval 1.73-2.90, P < 0.001). In addition, gestational hypertension was also significantly and independently correlated with subsequent type 2 diabetes mellitus risk (relative risk = 2.06, 95 % confidence interval 1.57-2.69, P < 0.001). The pooled estimates were not significantly altered in the subgroup analyses of studies on preeclampsia or gestational hypertension. Bayesian meta-analysis showed the relative risks of type 2 diabetes mellitus risk for individuals with hypertensive disorders during pregnancy, preeclampsia, and gestational hypertension were 1.59 (95 % credibility interval: 1.11-2.32), 2.27 (95 % credibility interval: 1.67-2.97), and 2.06 (95 % credibility interval: 1.41-2.84), respectively. Publication bias was not evident in the meta-analysis. Preeclampsia and gestational hypertension are independently associated with substantially elevated risk of type 2 diabetes mellitus in later life.
authors: Department of Obstetrics, Maternal and Children Health's Hospital of Weifang, Weifang, 261011, China. bennettzhwang@gmail.com.
authors: Zengfang
authors: http://orcid.org/0000-0002-6431-6552
authors: Z
authors: Wang
authors: Surgical Center, Zhucheng People's Hospital, Zhucheng, 262201, China.
authors: Zengyan
authors: Z
authors: Wang
authors: Department of Endocrinology, Affiliated Hospital of Qingdao University, Qingdao, 266003, China.
authors: Luang
authors: L
authors: Wang
authors: Department of Endocrinology, Affiliated Hospital of Qingdao University, Qingdao, 266003, China.
authors: Mingyue
authors: M
authors: Qiu
authors: Department of Endocrinology, Affiliated Hospital of Qingdao University, Qingdao, 266003, China.
authors: Yangang
authors: Y
authors: Wang
authors: Department of Endocrinology, Affiliated Hospital of Qingdao University, Qingdao, 266003, China.
authors: Xu
authors: X
authors: Hou
authors: Department of Medical Education, Health School of Ganzhou in Jiangxi Province, Ganzhou, 341000, China.
authors: Zhong
authors: Z
authors: Guo
authors: Department of Endocrinology, Affiliated Hospital of Qingdao University, Qingdao, 266003, China.
authors: Bin
authors: B
authors: Wang
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000175:diagnosis*; D011247:Pregnancy; D012306:Risk
keywords: Gestational hypertension; Preeclampsia; Type 2 diabetes