Correlation of hypertensive disorders and diabetes mellitus in pregnancy: a random sampling study in Beijing area

Abstract

Objective To assess the prevalence and association of hypertensive disorders and diabetes mellitus in pregnancy. Methods Fifteen hospitals in Beijing were randomly sampled from June 2013 to November 2013 and 15 194 deliveries were evaluated. Overall prevalence of maternal hypertensive disorders and diabetes mellitus in pregnancy were assessed. Prevalence of hypertensive disorders of pregnancy, preeclampsia and severe preeclampsia were compared among non-diabetes, gestational diabetes, and pre-gestational diabetes groups, as well as the prevalence of gestational diabetes between chronic hypertension and non-chronic hypertension groups. Logistic regression analysis was used to explore the association between risk factors and hypertensive disorders and diabetes mellitus. Risk factors included in the model were chronic hypertension, diabetes, age, parity, education status, family income, pre-gestational body mass index and gestational weight gain. Results The prevalence of hypertensive disorders, preeclampsia, severe preeclampsia and chronic hypertension was 4.4% (672/15 194), 2.7% (417/15 194), 1.8% (279/15 194) and 2.3% (350/15 194), respectively.The prevalence of gestational diabetes and pre-gestational diabetes was 19.7%(2 986/15 194)and 1.4%(208/15 194). When dividing the population into non-diabetic group, gestational diabetic group and pre-gestational diabetic group, the incidence of hypertensive disorders of pregnancy increased accordingly (3.8%(454/12 000), 6.2%(185/2 986), 15.9%(33/208), χ2=96.8, P<0.05), as well as the incidence of preeclampsia (2.4%(291/12 000), 3.7%(111/2 986), 7.2% (15/208), χ2=34.3, P<0.05) and severe preeclampsia (1.5%(184/12 000), 2.5%(75/2 986), 2.9%(6/208), χ2= 14.9, P<0.05). The incidence of gestational diabetes (31.4%(110/350) vs 19.4%(2 876/14 844), χ2=42.1, P< 0.05) and pre-gestational diabetes (7.1% (25/350) vs 1.2% (183/14 844), χ2=113.2, P<0.05) in the chronic hypertensive group were higher than those in the non-hypertensive group. Maternal body mass index before pregnancy (OR:1.22, 95% CI 1.15-1.29), gestational weight gain (1.08, 1.05-1.12), maternal complications of gestational diabetes (1.90, 1.20-3.01) and pre-gestational diabetes (4.44, 1.50-13.21) were identified as risk factors for hypertensive disorders. Significant risk factors for gestational diabetes were maternal body mass index (BMI) before pregnancy (1.09, 1.08-1.10), age (1.03, 1.02-1.04) and maternal complication of chronic hypertension (1.57, 1.23-2.00). Conclusion Hypertensive disorders of pregnancy and diabetes mellitus in pregnancy are closely correlated to each other. Pre-gestational diabetes and gestational diabetes are risk factors for hypertensive disorders of pregnancy. Chronic hypertension is a risk factor for gestational diabetes.Pre-gestational body mass index is the common risk factor for both diseases. Key words: Diabetes mellitus; Pregnancy; Hypertension; Prevalence; Risk factor