Risk of Subsequent Hypertension and Diabetes in Women With Hypertension During Pregnancy and Gestational Diabetes.
To assess risks of postpartum hypertension and diabetes mellitus (DM) for women with hypertension during pregnancy (HDP) with and without gestational DM (GDM).



From insurance data of 15- to 44-year-old women with pregnancy in 2000-2011, we established an HDP/GDM cohort (n=1270), an HDP/non-GDM cohort (n=5077), and a comparison cohort without either disorder (n=12,594), frequency matched by age and year of pregnancy. Postpartum hypertension and DM were assessed before 2012.



The postpartum hypertension incidence increased with age in all cohorts, with overall rates of 13.1, 8.82, and 0.79 per 1000 person-years in the HDP/GDM, HDP/non-GDM, and comparison cohorts, respectively. The adjusted hazard ratios (aHRs) of hypertension were 16.8 (95% CI, 11.8-24.1) for the HDP/GDM cohort and 11.2 (95% CI, 8.19-15.2) for the HDP/non-GDM cohort relative to the comparison cohort. The corresponding incident DM rates were 41.9 and 8.06 vs 2.55 per 1000 person-years in the 3 cohorts, respectively, with aHRs of 16.2 (95% CI, 13.2-19.9) for the HDP/GDM cohort and 3.15 (95% CI, 2.55-3.89) for the HDP/non-GDM cohort relative to the comparison cohort. Incident DM in the HDP/GDM cohort was 44% greater in 15- to 29-year-old women vs 40- to 44-year-old women (49.1 vs 34.2 per 1000 person-years), with aHRs of 39.2 (95% CI, 24.5-62.7) and 5.52 (95% CI, 2.92-10.4), respectively, relative to comparisons of respective age groups.



Subsequent hypertension and DM risks are greater in women with HDP/GDM than in women with HDP only compared with women without these complications. Younger women with HDP/GDM should be particularly cautious.
Department of Public Health, China Medical University College of Public Health, Taichung, Taiwan; Department of Nursing, Cheng Ching Hospital, Taichung, Taiwan.
Lien-Jen
LJ
Hwu
Department of Health Services Administration, China Medical University College of Public Health, Taichung, Taiwan; Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.
Fung-Chang
FC
Sung
Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan; Institute of Clinical Medical Science, China Medical University College of Medicine, Taichung, Taiwan.
Chih-Hsin
CH
Mou
Institute of Clinical Medical Science, China Medical University College of Medicine, Taichung, Taiwan.
I-Kuan
IK
Wang
Department of Nursing, China Medical University Hospital, Taichung, Taiwan; School of Nursing, China Medical University, Taichung, Taiwan.
Hsin-Hsin
HH
Shih
Department of Obstetrics and Gynaecology, China Medical University Hospital, Taichung, Taiwan.
Yin-Yi
YY
Chang
Department of Nursing, China Medical University Hospital, Taichung, Taiwan; School of Nursing, China Medical University, Taichung, Taiwan. Electronic address: tyaling@mail.cmu.edu.tw.
Ya-Ling
YL
Tzeng
D000328:Adult; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000209:etiology*; D016640:Diabetes, Gestational; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology*; D046110:Hypertension, Pregnancy-Induced; D015994:Incidence; D008875:Middle Aged; D011247:Pregnancy; D016016:Proportional Hazards Models; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult