The incidence of pregnancy-induced hypertension among patients with carbohydrate intolerance

Objective: To determine the association between pregnancy-induced hypertens ion (PIH) and carbohydrate intolerance in pregnancy. Methods: Data on singleton pregnancies were retrieved from the obstetric da tabase of University Hospital, Kuala Lumpur. Gestational impaired glucose t olerance (GIGT) and gestational diabetes mellitus (GDM) were defined accord ing to the World Health Organization criteria. Established diabetes mellitu s (EDM) was defined as diabetes mellitus diagnosed prior to pregnancy. PIH was diagnosed according to the criteria of the International Society for th e Study of Hypertension in Pregnancy. Maternal characteristics were compare d between groups using analysis of variance (ANOVA) and incidence counts us ing the chi-squared test. Logistic regression analysis using the presence o f PIH as the response variable was used to study the association among GDM, GIGT, EDM, and PIH, controlling for maternal factors Main Outcome Measures: To determine the incidence of PIH among patients wit h glucose intolerance and the independent risk factors for the development of PIH. Results: There were 24,290 singleton pregnancies retrieved from the databas e. Both the prevalence of carbohydrate intolerance and the incidence of PIH differed among the three principal ethnic groups (p < 0.0001). There was a significant association between PIH and both a higher maternal age (OR = 1 .04, p < 0.0001) and a higher maternal body mass index (BMI) at delivery (O R = 1.14 per unit increment, p < 0.0001). After adjusting for maternal age, BMI, parity, and ethnic origin, using logistic regression, there was a sig nificant residual risk of PIH among individuals with GIGT, GDM, or EDM. Conclusions: Patients with carbohydrate intolerance of varying severity are at increased risk of developing PIH. Our findings lend credence to the the ory that carbohydrate intolerance and PIH share a common etiology.