Women with hypertensive disorders of pregnancy, including preeclampsia and gestational hypertension, have high likelihood of dysglycemia developing in the early postpartum period, according to study results published in the Canadian Journal of Diabetes. Targeted postpartum glycemic screening in women with hypertensive disorders of pregnancy is warranted.

The study included women who delivered singleton live-born infants in Calgary, Canada, between January 2010 and December 2012 (n=27,300). The researchers linked participant data with Calgary Laboratory Services data for glycemic tests and prescriptions in the Pharmaceutical Information Network for antidiabetes medication over the first 4 years postpartum.

The researchers used logistic regression analyses to compare glycemic screening and status, adjusting for maternal age, gestational age, parity, and the Pampalon deprivation index, a measure of socioeconomic status commonly used in Canadian research.

The results indicated that women with hypertensive disorders of pregnancy were more likely to have any glycemic screening (women with gestational hypertension: 67.8%; women with preeclampsia: 69.9%) compared with normotensive women (60.9%; P <.001).

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Women with hypertensive disorders of pregnancy had higher mean fasting plasma glucose levels (women with gestational hypertension: 4.82±0.51 mmol/L; women with preeclampsia: 4.84±0.54 mmol/L) compared with normotensive women (4.73±0.49 mmol/L; P <.001). In addition, women with hypertensive disorders of pregnancy had higher random plasma glucose levels (women with gestational hypertension: 5.20±0.96 mmol/L; women with preeclampsia: 5.39±1.71 mmol/L) compared with normotensive women (5.00±0.87 mmol/L; P <.001).

The researchers also found that women with hypertensive disorders of pregnancy had an increased adjusted odds of type 2 diabetes developing in the first 4 years postpartum compared with normotensive women (women with gestational hypertension: 2.26; 95% CI, 1.50-13.4; P <.001; women with preeclampsia: 2.02; 95% CI, 0.91-4.46; P =.084).

“While these findings highlight the importance of early targeted postpartum glycemic screening for dysglycemia, they also demonstrate a compelling need for further research on optimal screening tests in these high-risk postpartum women,” the researchers wrote.

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Reference

Wen C, Metcalfe A, Anderson T, et al. Risks of dysglycemia over the first four years after a hypertensive disorder of pregnancy [published online July 25, 2019]. Can J Diabetes. doi:10.1016/j.jcjd.2019.07.150