Long-term risk of diabetes following hypertensive disorders of pregnancy: A retrospective cohort study.

IF 4.2 3区医学 Q1 ENDOCRINOLOGY & METABOLISM

World Journal of Diabetes Pub Date : 2025-06-15 DOI:10.4239/wjd.v16.i6.105080

Yu-Hsiang Shih, Chiao-Yu Yang, Chia-Chi Lung

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Abstract

Background: The impact of varying degrees of pregnancy-induced hypertension (PIH) on the risk of developing diabetes later in life is currently unknown.

Aim: To assess the long-term risks of type 2 diabetes mellitus (T2DM), prediabetes, and mortality that are associated with hypertensive disorders of pregnancy.

Methods: This retrospective cohort study used the TriNetX United States Collaborative Network to examine outcomes, especially T2DM, prediabetes and mortality, related to hypertensive disorders of pregnancy in females aged 21-45. Participants had no history of hypertension or diabetes before pregnancy or before 20 weeks of gestation. Propensity score matching was applied to balance covariates such as gestational diabetes, polycystic ovarian syndrome, chronic kidney disease, hyperlipidemia, overweight/obesity, nicotine dependence, alcohol abuse, and healthcare utilization. This ensured comparability between groups and reduced potential confounding in outcome evaluation.

Results: This study included 318544 females aged 21-45 with and without PIH. Females with PIH had higher risks of T2DM [hazard ratio (HR): 1.907, 95% confidence interval (CI): 1.821-1.998), prediabetes (HR: 1.610, 95%CI: 1.537-1.687), and mortality (HR: 1.501, 95%CI: 1.361-1.655) over a follow-up of up to 18 years. Incidence rates for T2DM, prediabetes, and mortality were 3.2%, 2.7%, and 0.6%, respectively. Subgroup analyses showed that the presence of gestational hypertension, preeclampsia, and eclampsia increased risks across all outcomes. Persistent hypertension beyond 12 weeks postpartum was linked to more than a 3-fold increase in mortality. Preventative aspirin use during pregnancy did not reduce the risks of T2DM, prediabetes, or mortality among those with PIH.

Conclusion: PIH significantly increases the long-term risks of T2DM, prediabetes, and mortality, highlighting the urgent need for improved long-term management strategies to enhance overall health in such individuals.

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妊娠期高血压疾病后糖尿病的长期风险：一项回顾性队列研究

背景：不同程度的妊高征（PIH）对日后患糖尿病风险的影响目前尚不清楚。目的：评估与妊娠期高血压疾病相关的2型糖尿病（T2DM）、前驱糖尿病和死亡率的长期风险。方法：本回顾性队列研究使用TriNetX美国合作网络来检查与21-45岁女性妊娠高血压疾病相关的结局，特别是T2DM、糖尿病前期和死亡率。参与者在怀孕前或怀孕20周前没有高血压或糖尿病史。倾向评分匹配用于平衡协变量，如妊娠糖尿病、多囊卵巢综合征、慢性肾病、高脂血症、超重/肥胖、尼古丁依赖、酒精滥用和医疗保健利用。这确保了组间的可比性，减少了结果评估中的潜在混淆。结果：本研究纳入318544名年龄在21-45岁的女性，伴有或不伴有PIH。在长达18年的随访中，PIH女性患T2DM的风险更高[危险比（HR）： 1.907, 95%可信区间（CI）： 1.821-1.998]、前驱糖尿病（HR: 1.610, 95%CI: 1.537-1.687）和死亡率（HR: 1.501, 95%CI: 1.361-1.655）。T2DM、前驱糖尿病和死亡率的发病率分别为3.2%、2.7%和0.6%。亚组分析显示，妊娠期高血压、先兆子痫和子痫的存在增加了所有结局的风险。产后超过12周的持续高血压与死亡率增加3倍以上有关。妊娠期预防性使用阿司匹林并不能降低PIH患者发生2型糖尿病、前驱糖尿病或死亡率的风险。结论：PIH显著增加了T2DM、前驱糖尿病和死亡率的长期风险，强调了改善这些个体的长期管理策略以提高整体健康水平的迫切需要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

World Journal of Diabetes ENDOCRINOLOGY & METABOLISM-

自引率

2.40%

发文量

909

期刊介绍： The WJD is a high-quality, peer reviewed, open-access journal. The primary task of WJD is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of diabetes. In order to promote productive academic communication, the peer review process for the WJD is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJD are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in diabetes. Scope: Diabetes Complications, Experimental Diabetes Mellitus, Type 1 Diabetes Mellitus, Type 2 Diabetes Mellitus, Diabetes, Gestational, Diabetic Angiopathies, Diabetic Cardiomyopathies, Diabetic Coma, Diabetic Ketoacidosis, Diabetic Nephropathies, Diabetic Neuropathies, Donohue Syndrome, Fetal Macrosomia, and Prediabetic State.