Am J Epidemiol 2003; 158:1148-1153.
Copyright © 2003 by the Johns
Hopkins Bloomberg School of Public Health
ORIGINAL CONTRIBUTIONS |
Association between Gestational Diabetes and Pregnancy-induced Hypertension
1 VA Puget Sound Health Services Research and Development, Seattle, WA.
2 Division of General Internal Medicine, Department of Medicine, University of Washington, Seattle, WA.
3 Division of Gastroenterology, Department of Medicine, University of Washington, Seattle, WA.
4 Department of Epidemiology, University of Washington School of Public Health, Seattle, WA.
Gestational diabetes and pregnancy-induced hypertension are common, and their relation is not well understood. The authors conducted a population-based case-control study using 1992–1998 Washington State birth certificate and hospital discharge records to investigate this relation. Consecutive cases of pregnancy-induced hypertension were divided into four groups based on International Classification of Diseases, Ninth Revision codes: eclampsia (n = 154), severe preeclampsia (n = 1,180), mild preeclampsia (n = 5,468), and gestational hypertension (n = 8,943). Cases were compared with controls who did not have pregnancy-induced hypertension (n = 47,237). Gestational diabetes was more common in each case group (3.9% in eclamptics, 4.5% in severe preeclamptics, and 4.4% in both mild preeclamptics and those with gestational hypertension) than in controls (2.7%). After adjustment for body mass index, age, ethnicity, parity, and prenatal care, gestational diabetes was associated with increased risk of severe preeclampsia (odds ratio (OR) = 1.5, 95% confidence interval (CI): 1.1, 2.1), mild preeclampsia (OR = 1.5, 95% CI: 1.3, 1.8), and gestational hypertension (OR = 1.4, 95% CI: 1.2, 1.6). Gestational diabetes was more strongly associated with pregnancy-induced hypertension among women who received less prenatal care (OR = 4.2 for eclampsia and OR = 3.1 for severe preeclampsia, p < 0.05 for both) and among Black women (OR for eclampsia and preeclampsia together = 3.9, p < 0.05).
diabetes, gestational; eclampsia; ethnic groups; hypertension; pre-eclampsia; pregnancy complications; pregnancy complications, cardiovascular; prenatal care
Abbreviations: Abbreviations: CI, confidence interval; ICD-9, International Classification of Diseases, Ninth Revision; OR, odds ratio.
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