Citation
Rice, Madeline Murguia; Landon, Mark B.; Varner, Michael W.; Casey, Brian M.; Reddy, Uma M.; Wapner, Ronald J.; Rouse, Dwight J.; Biggio, Joseph R., Jr.; Thorp, John M., Jr.; & Chien, Edward K., et al. (2016). Pregnancy-Associated Hypertension in Glucose-Intolerant Pregnancy and Subsequent Metabolic Syndrome. Obstetrics & Gynecology, 127(4), 771-779. PMCID: PMC4805433Abstract
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.
CONCLUSION: 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.
URL
http://dx.doi.org/10.1097/aog.0000000000001353Reference Type
Journal ArticleYear Published
2016Journal Title
Obstetrics & GynecologyAuthor(s)
Rice, Madeline MurguiaLandon, Mark B.
Varner, Michael W.
Casey, Brian M.
Reddy, Uma M.
Wapner, Ronald J.
Rouse, Dwight J.
Biggio, Joseph R., Jr.
Thorp, John M., Jr.
Chien, Edward K.
Saade, George R.
Peaceman, Alan M.
Blackwell, Sean C.
VanDorsten, J. Peter, for the
Eunice Kennedy Shriver
National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network