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Effects of preeclampsia on perinatal outcomes in women with gestational diabetes mellitus: A retrospective cohort study

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International Journal of Diabetes in Developing Countries Aims and scope Submit manuscript

Abstract

Background

To date, studies on the effects of preeclampsia on perinatal outcomes in women with gestational diabetes mellitus (GDM) are comparatively few, and the results are inconsistent.

Objective

This study aimed to explore the effects of preeclampsia on perinatal outcomes in women with GDM.

Methods

This retrospective cohort study collected data of women with GDM whose babies were delivered in a Chinese hospital between July 2017 and June 2020. We divided eligible pregnant women with GDM into two groups based on whether they were diagnosed with preeclampsia: GDM with preeclampsia group and GDM without preeclampsia group. Logistic regression analysis was performed to evaluate the risks for perinatal outcomes which were used as the dependent variables.

Results

We identified 7533 eligible women with GDM (245 in GDM with preeclampsia group and 7288 in GDM without preeclampsia group). After adjusting for covariates, preeclampsia was significantly associated with higher risks of fetal malformations (OR: 1.67, 95% CI: 1.08–2.57), fetal growth restriction (OR: 5.36, 95% CI: 2.91–9.88), cesarean section (OR: 2.48, 95% CI: 1.83–3.37), emergency cesarean section (OR: 2.32, 95% CI: 1.77–3.05), preterm birth (OR: 1.89, 95% CI: 1.27–2.81), low birth weight (LBW) (OR: 3.30, 95% CI: 2.16–5.05), small for gestational age (SGA) (OR: 3.05, 95% CI: 2.01–4.63) and neonatal hypoglycemia (OR: 1.77, 95% CI: 1.10–2.85).

Conclusion

Women with GDM complicated with preeclampsia were at higher risks of fetal malformations, fetal growth restriction, cesarean section, emergency cesarean section, preterm birth, LBW, SGA and neonatal hypoglycemia.

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Data availability

The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. International Diabetes Federation. IDF Diabetes Atlas 10th edition. https://diabetesatlas.org/atlas/tenth-edition/. Accessed 29 Mar 2022].

  2. Abalos E, Cuesta C, Grosso AL, Chou D, Say L. Global and regional estimates of preeclampsia and eclampsia: a systematic review. Eur J Obstet Gynecol Reprod Biol. 2013;170:1–7. https://doi.org/10.1016/j.ejogrb.2013.05.005.

    Article  PubMed  Google Scholar 

  3. Gao C, Sun X, Lu L, Liu F, Yuan J. Prevalence of gestational diabetes mellitus in mainland China: A systematic review and meta-analysis. J Diabetes Invest. 2019;10:154–62. https://doi.org/10.1111/jdi.12854.

    Article  CAS  Google Scholar 

  4. Li F, Qin J, Zhang S, Chen L. Prevalence of hypertensive disorders in pregnancy in China: A systematic review and meta-analysis. Pregnancy hypertens. 2021;24:13–21. https://doi.org/10.1016/j.preghy.2021.02.001.

    Article  PubMed  Google Scholar 

  5. Plows J, Stanley J, Baker P, Reynolds C, Vickers M. The Pathophysiology of Gestational Diabetes Mellitus. Int J Mol Sci. 2018;19:3342. https://doi.org/10.3390/ijms19113342.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Billionnet C, Mitanchez D, Weill A, Nizard J, Alla F, Hartemann A, et al. Gestational diabetes and adverse perinatal outcomes from 716,152 births in France in 2012. Diabetologia. 2017;60:636–44. https://doi.org/10.1007/s00125-017-4206-6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Shen M, Smith GN, Rodger M, White RR, Walker MC, Wen SW, et al. Comparison of risk factors and outcomes of gestational hypertension and pre-eclampsia. Plos One. 2017;12:e175914. https://doi.org/10.1371/journal.pone.0175914.

    Article  CAS  Google Scholar 

  8. Sibai B, Dekker G, Kupferminc M. Pre-eclampsia. Lancet. 2005;365:785–99. https://doi.org/10.1016/S0140-6736(05)17987-2.

    Article  PubMed  Google Scholar 

  9. Östlund I, Haglund B, Hanson U. Gestational diabetes and preeclampsia. Eur J Obstet Gyn R B. 2004;113:12–6. https://doi.org/10.1016/j.ejogrb.2003.07.001.

    Article  Google Scholar 

  10. Sun Y, Yang H, Sun WJ. Risk factors for pre-eclampsia in pregnant Chinese women with abnormal glucose metabolism. Int J Gynaecol Obstet. 2008;101:74–6. https://doi.org/10.1016/j.ijgo.2007.10.008.

    Article  CAS  PubMed  Google Scholar 

  11. Schneider S, Freerksen N, Röhrig S, Hoeft B, Maul H. Gestational diabetes and preeclampsia – Similar risk factor profiles? Early Hum Dev. 2011;88:179–84. https://doi.org/10.1016/j.earlhumdev.2011.08.004.

    Article  PubMed  Google Scholar 

  12. Sibai BM, Ross MG. Hypertension in gestational diabetes mellitus: Pathophysiology and long-term consequences. J Matern Fetal Neonatal Med. 2010;23:229–33. https://doi.org/10.3109/14767050903550899.

    Article  PubMed  Google Scholar 

  13. Chen ZY, Chen J. Risk factors and pregnancy outcomes analysis of gestational diabetes mellitus complicated with preeclampsia. Matern Child Health Care China. 2017;32:2616–8. https://doi.org/10.7620/zgfybj.j.issn.1001-4411.2017.12.38.

    Article  CAS  Google Scholar 

  14. Shi W, Peng XX, Ma XH. Characteristics of gestational diabetes mellitus combined with pre-eclampsia and the effects on pregnancy outcomes. Chin J Med. 2018;53:1006–8. https://doi.org/10.3969/j.issn.1008-1070.2018.09.016.

    Article  Google Scholar 

  15. Zhao J, Xu F. Analysis of pregnancy outcome of gestational diabetes mellitus complicated with preeclampsia. J Wenzhou Med Coll. 2012;42:63–5. https://doi.org/10.3969/j.issn.1000-2138.2012.01.018.

    Article  Google Scholar 

  16. Nunes JS, Ladeiras R, Machado L, Coelho D, Duarte C, Furtado JM. The Influence of Preeclampsia, Advanced Maternal Age and Maternal Obesity in Neonatal Outcomes Among Women with Gestational Diabetes. Rev Bras Ginecol Obstet. 2020;42:607–13. https://doi.org/10.1055/s-0040-1710300.

    Article  PubMed  Google Scholar 

  17. Metzger BE, Gabbe SG, Persson B, Buchanan TA, Catalano PM, Damm P, et al. International Association of Diabetes and Pregnancy Study Groups Recommendations on the Diagnosis and Classification of Hyperglycemia in Pregnancy. Diabetes Care. 2010;33:676–82. https://doi.org/10.2337/dc09-1848.

    Article  CAS  PubMed  Google Scholar 

  18. Hypertension Disorders of Pregnancy Subgroup. Chinese Society of Obstetrics and Gynecology, Chinese Medical Association. Diagnosis and treatment guideline for hypertension disorders of pregnancy. Chin J Obstet Gynecol. 2015;50:721–8. https://doi.org/10.3760/cma.j.issn.0529-567x.2015.10.001.

    Article  Google Scholar 

  19. Rasmussen K, Yaktine A. Weight Gain During Pregnancy: Reexamining the Guidelines. Washington DC: The National Academies Press (US); 2009.

    Google Scholar 

  20. Department of Obstetrics and Gynecology Chinese Medical Association. Guidelines for Prevention and Management of Postpartum Hemorrhage (2014). Chin J Obstet Gynecol. 2014;49:641–6. https://doi.org/10.3760/cma.j.issn.0529-567x.2014.09.001.

    Article  Google Scholar 

  21. Fetal Medicine Subgroup, Society of perinatal Medicine, Chinese Medical Association, Obstetrics Subgroup, Society of Obstetrics and Gynecology, Chinese Medical Association. Expert consensus on fetal growth restriction. Chin J Perinat Med. 2019;22:361–80. https://doi.org/10.3760/cma.j.issn.1007-9408.2019.06.001.

    Article  Google Scholar 

  22. Dai L, Deng C, Li Y, Zhu J, Mu Y, Deng Y, et al. Birth weight reference percentiles for Chinese. Plos One. 2014;9:e104779. https://doi.org/10.1371/journal.pone.0104779.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Balsells M, Garcia-Patterson A, Gich I, Corcoy R. Major congenital malformations in women with gestational diabetes mellitus: a systematic review and meta-analysis. Diabetes Metab Res Rev. 2012;28:252–7. https://doi.org/10.1002/dmrr.1304.

    Article  PubMed  Google Scholar 

  24. Lai FY, Johnson JA, Dover D, Kaul P. Outcomes of singleton and twin pregnancies complicated by pre-existing diabetes and gestational diabetes: A population-based study in Alberta, Canada, 2005–2011. J Diabetes. 2016;8:45–55. https://doi.org/10.1111/1753-0407.12255.

    Article  PubMed  Google Scholar 

  25. Nelson DB, Chalak LF, McIntire DD, Leveno KJ. Is preeclampsia associated with fetal malformation? A review and report of original research. J Matern Fetal Neonatal Med. 2015;28:2135–40. https://doi.org/10.3109/14767058.2014.980808.

    Article  PubMed  Google Scholar 

  26. Joo EH, Kim YR, Kim N, Jung JE, Han SH, Cho HY. Effect of Endogenic and Exogenic Oxidative Stress Triggers on Adverse Pregnancy Outcomes: Preeclampsia, Fetal Growth Restriction, Gestational Diabetes Mellitus and Preterm Birth. Int J Mol Sci. 2021;22:10122. https://doi.org/10.3390/ijms221810122.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Phaloprakarn C, Tangjitgamol S. Risk assessment for preeclampsia in women with gestational diabetes mellitus. J Perinat Med. 2009;37:617. https://doi.org/10.1515/JPM.2009.108.

    Article  PubMed  Google Scholar 

  28. Yogev Y, Xenakis EM, Langer O. The association between preeclampsia and the severity of gestational diabetes: the impact of glycemic control. Am J Obstet Gynecol. 2004;191(5):1655–60. https://doi.org/10.1016/j.ajog.2004.03.074.

    Article  PubMed  Google Scholar 

  29. Crowther CA, Hiller JE, Moss JR, McPhee AJ, Jeffries WS, Robinson JS. Effect of treatment of gestational diabetes mellitus on pregnancy outcomes. N Engl J Med. 2005;352:2477–86. https://doi.org/10.1056/NEJMoa042973.

    Article  CAS  PubMed  Google Scholar 

  30. Hartling L, Dryden DM, Guthrie A, Muise M, Vandermeer B, Donovan L. Benefits and harms of treating gestational diabetes mellitus: a systematic review and meta-analysis for the US Preventive Services Task Force and the National Institutes of Health Office of Medical Applications of Research. Ann Intern Med. 2013;159:123–9. https://doi.org/10.7326/0003-4819-159-2-201307160-00661.

    Article  PubMed  Google Scholar 

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Funding

This work was supported by the National Natural Science Foundation of China (Grant No. 81903334).

Author information

Authors and Affiliations

  1. School of Nursing, Wuhan University, Wuhan, China

    Ruixue Tian, Jingqi Xu, Jing He, Yanqun Liu, Xiaoli Chen & Zhijie Zou

  2. Obstetrics department, Chongqing Health Center for Women and Children, Chongqing, China

    Jing He & Zhen Chen

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  1. Ruixue Tian
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  4. Zhen Chen
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Contributions

Ruixue Tian designed the study, collected and analyzed the data, and drafted the manuscript. Jingqi Xu collected the data, cleaned the data and contributed to the interpretation of the data. Jing He designed the study and managed the data. Zhen Chen contributed to the interpretation of the data and reviewed the manuscript. Yanqun Liu designed the study and managed the data. Xiaoli Chen and Zhijie Zou designed the study and revised the manuscript. All authors gave their final approval for this version of the manuscript to be published.

Corresponding authors

Correspondence to Xiaoli Chen or Zhijie Zou.

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Competing interests

The authors declare no competing interests.

Ethics approval

This study was approved by the ethics committee of Chongqing Health Center for Women and Children (No. 2020–022) and performed in accordance with the Declaration of Helsinki.

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Written informed consent for participation was not required because of the retrospective, anonymous nature of the study..

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Tian, R., Xu, J., He, J. et al. Effects of preeclampsia on perinatal outcomes in women with gestational diabetes mellitus: A retrospective cohort study. Int J Diabetes Dev Ctries (2023). https://doi.org/10.1007/s13410-023-01236-x

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