478: Women with gestational diabetes or lesser degrees of glucose intolerance have a greater risk of preeclampsia

Abstract

INTOLERANCE HAVE A GREATER RISK OF PREECLAMPSIA DARCY CARR, KATHERINE NEWTON, KRISTINA UTZSCHNEIDER, MIRJAM FAULENBACH, STEVEN KAHN, SUSAN HECKBERT, THOMAS EASTERLING, University of Washington, Seattle, Washington, Group Health Center for Health Studies, Seattle, Washington, VA Puget Sound Health Care System, Seattle, Washington OBJECTIVE: Preeclampsia and type 2 diabetes are both associated with obesity and insulin resistance. We hypothesized that women who have higher glucose levels on the 50 gm, 1-hr oral glucose challenge test (OGCT), one abnormal value on the 100 gm, 3-hr oral glucose tolerance test (OGTT), or gestational diabetes mellitus (GDM) would have a greater frequency of preeclampsia. STUDY DESIGN: We performed a retrospective cohort study among 26,105 women who delivered between 1985 and 2002 at Group Health in Washington state who received care for 1 year before delivery, had an OGCT or OGTT, and did not have preexisting hypertension or diabetes. Preeclampsia was defined by ICD-9 codes. RESULTS: The women were 30.3 6.2 years old. Preeclampsia developed in 1,809 (6.9%) women. The risk of preeclampsia increased across 1-hr OGCT quartiles adjusting for age, primigravidity, and GDM compared to the reference group (OGCT 97 mg/dl; Table 1). Among the 6,222 women with a 3-hr OGTT, 3,639 had a normal OGTT and 6.5% developed preeclampsia; 1,253 had one abnormal value and 8.7% developed preeclampsia; and 1,330 had GDM (2 abnormal values by Carpenter and Coustan criteria) and 9.2% developed preeclampsia. Women with abnormal OGTT values had a higher risk of preeclampsia compared to those with normal values adjusting for age and primigravidity (Table 2).