[Glycemic control and the risk of preeclampsia in women with gestational diabetes mellitus]

Abstract

Introduction: Gestational diabetes mellitus (GDM) is associated with an increased risk of preeclampsia and other complications throughout pregnancy.

Aim: The aim of the study was to analyze the incidence of preeclampsia and other risk factors in GDM pregnant women.

Study design and methods: During 1992-2001 period, 472 consecutive unselected pregnancies were followed up in women with GDM. Glycemic control was assessed by HbA1c at the time of diagnosis. Preeclampsia was defined as blood pressure 140/90 mm Hg combined with albuminuria of >0.3 g/L. The occurrence of preeclampsia was also assessed in a control group comprising 324 unselected pregnant women.

Results: Preeclampsia developed in 14.4% of GDM women and 4.3% of controls. After adjustment by logistic regression, both fasting blood glucose (FBG) and profile blood glucose (PBG) and their changes during pregnancy remained significant predictors for preeclampsia. The odds for preeclampsia increased by a factor 1.2 for each 1 mmol/L increment in initial FBG level and PBG level, and decreased by factor 0.8 for each 1 mmol/L decrease of FBG or PBG level achieved during pregnancy.

Conclusion: Improvement of the glycemic control during pregnancy reduces the risk of preeclampsia.