1192-P: Risk Factors Associated with Preeclampsia in Pregnant Patients with Diabetes

Abstract

To determine risk factors associated with pre-eclampsia (PreE) among pregnant patients with diabetes. We performed a case-control study of PreE among pregnant patients with pre-existing and gestational diabetes at a tertiary referral center from 2007-2017. Inclusion criteria were age ≥18 years and English speaking. Lethal anomalies, delivery <23 weeks, and multiple gestations were excluded. Clinical characteristics including advanced maternal age (AMA) ≥35 years old, chronic hypertension (CHTN), diabetes type, insulin use, and HbA1c ≥ 6.5% at any point during pregnancy were compared between groups using univariate regression. A multivariable logistic regression model was used to adjust for potential confounders, including AMA and obesity (BMI ≥30 kg/m2). A total of 503 patients met study criteria: 40 (8.0%) with type 1 DM, 200 (39.8%) with type 2 DM, and 263 (52.3%) with GDM. PreE was diagnosed in 102 (20.3%) patients in the sample. Demographics were similar except patients with PreE were older and more likely to be obese than those without PreE. Compared to patients with diabetes who did not have preE, those with preE were significantly more likely to have type 2 DM (64.7% PreE vs. 33.4% no PreE; aOR 6.78; 95% CI 3.08-14.94), CHTN (60.8% PreE vs. 24.9% no PreE; aOR 7.74; 95% CI 3.63-16.50), insulin use (76.5% PreE vs. 57.5% no PreE; aOR 3.70; 95% CI 1.63-8.42), and HbA1c≥6.5% (PreE 61.8% vs. no PreE 38.2%; aOR 4.49; 95% CI 2.18-9.26). Those with PreE were less likely to have GDM (27.5% PreE vs. 58.6% no PreE; aOR 0.19; 95% CI 0.09-0.41). There was no difference among patients with AMA or type 1 DM. Patients with PreE are more likely to have pregestational diabetes, co-existing CHTN and have worse glycemic control. This finding underscores the importance of glycemic control as a potentially protective factor against PreE. Disclosure M.Brady: None. E.B.Carter: None. R.Paul: None. N.Raghuraman: Other Relationship; HCFocus. V.Garr barry: None. F.Zhang: None. J.Kelly: None. Funding American Diabetes Association (1-19-ACE-02 to E.B.C.)