Prevalence and Risk Factors of Preeclampsia in Pregnant Women With Gestational Diabetes Mellitus.

Aims/Background Pregnant women with gestational diabetes mellitus (GDM) are at an increased risk of developing preeclampsia, a condition that not only threatens maternal and fetal safety but also compromises organ function. This study aimed to determine the prevalence of preeclampsia among pregnant women with GDM in China and to identify its associated risk factors. Methods A total of 212 GDM patients who underwent prenatal care and delivery at Beilun District People's Hospital between September 2020 and September 2024 were included in the study. Participants were divided into a preeclampsia group (PE group) and a non-preeclampsia group (Non-PE group) based on the presence or absence of preeclampsia. Clinical and demographic data were extracted from the medical record system and compared between the two groups. Univariate and multivariate analyses were conducted to identify factors influencing the occurrence of preeclampsia. Receiver operating characteristics (ROC) curves were used to evaluate the predictive efficacy of statistically different indicators. Results Among the 212 GDM patients, 60 developed preeclampsia (PE group), while 152 did not (Non-PE group), resulting in a preeclampsia prevalence of 28.30% (60/212). Multivariate logistic regression analysis identified high systolic blood pressure (SBP) (p < 0.001), high diastolic blood pressure (DBP) (p = 0.002), elevated body mass index (BMI) (p < 0.001), increased glycated hemoglobin (HbA1c) (p = 0.007), and high blood urea nitrogen (BUN) (p = 0.017) as independent risk factors for preeclampsia in GDM patients. The predictive value for preeclampsia was assessed using ROC curve analysis. When BMI was ≥23.205 kg/m², the area under the curve (AUC) was 0.695 [p < 0.001, 95% CI (0.612, 0.778)], with a sensitivity of 0.683 and specificity of 0.632. For HbA1c ≥5.550%, the AUC was 0.665 [p < 0.001, 95% CI (0.583, 0.747)], with a sensitivity of 0.617 and specificity of 0.658. When BUN was ≥4.250 mmol/L, the AUC was 0.692 [p < 0.001, 95% CI (0.612, 0.772)], with a sensitivity of 0.550 and specificity of 0.763; The combined prediction model of these three parameters yielded an AUC of 0.826 [p < 0.001, 95% CI (0.759, 0.892)], with a sensitivity of 0.783 and specificity of 0.803. Conclusion The prevalence of preeclampsia was significantly higher among patients with GDM. In addition to blood pressure, BMI, HbA1c, and BUN levels are key factors associated with preeclampsia risk and may be used together to assist in predicting GDM patients with preeclampsia. It is necessary to pay more attention to the high-risk groups of preeclampsia and formulate targeted health management strategies to reduce the risk of preeclampsia and improve maternal and neonatal outcomes.