Skip to main content
SpringerLink
Log in

Hypertensive Disorders of Pregnancy in Gestational Diabetes

  • Chapter
  • First Online:
Book cover Nutrition and Diet in Maternal Diabetes

Part of the book series: Nutrition and Health ((NH))

  • 1729 Accesses

Abstract

Hypertensive disorders of pregnancy are associated to gestational diabetes. Modifiable risk factors include obesity, glycemic control, and gestational weight gain in this order. Hypertensive disorders may occur in early, late pregnancy, or postpartum. Small for gestational age birthweight, restriction of fetal growth, indicated preterm delivery and maternal organ dysfunction are possible consequences of hypertensive disorders. Meta-inflammation, oxidative stress, impairment of immunity and final dysfunction of the endothelium may be crucial in the pathogenesis. These mechanisms seem to be influenced by insulin resistance, mostly in women that develop hypertensive disorders and diabetes toward mid-pregnancy. Prior to pregnancy, insulin resistance may be a relevant risk factor in women with obesity, impaired glucose tolerance, chronic hypertension, or smoking habit. This cluster of risk factors may anticipate cardiovascular disease in middle-aged women with history of hypertensive disorders of pregnancy.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Abbreviations

HDP:

Hypertensive disorders of pregnancy

GDM:

Gestational diabetes mellitus

TNF:

Tumoral necrosis factor

BP:

Blood pressure

CI:

Confidence interval

OGTT:

Oral glucose tolerance test

IGT:

Impaired glucose tolerance

IFG:

Impaired fasting glucose

References

  1. Goldman M, Kitzmiller JL, Abrams B, Cowan RM, Laros RK. Obstetric complications with GDM. Effects of maternal weight. Diabetes. 1991;40(Suppl 2):79–82.

    Article  PubMed  Google Scholar 

  2. Beucher G, Viaris de Lesegno B, Dreyfus M. Maternal outcome of gestational diabetes mellitus. Diabetes Metab. 2010;36:522–37.

    Article  CAS  PubMed  Google Scholar 

  3. Ray JG, Vermeulen MJ, Shapiro JL, Kenshole AB. Maternal and neonatal outcomes in pregestational and gestational diabetes mellitus, and the influence of maternal obesity and weight gain: the DEPOSIT study. Diabetes Endocrine Pregnancy Outcome Study in Toronto. QJM. 2001;94:347–56.

    Article  CAS  PubMed  Google Scholar 

  4. Yogev Y, Xenakis EMJ, Langer O. The association between preeclampsia and the severity of gestational diabetes: the impact of glycemic control. Am J Obstet Gynecol. 2004;191:1655–60.

    Article  PubMed  Google Scholar 

  5. 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.

    Article  CAS  PubMed  Google Scholar 

  6. Landon MB, Spong CY, Thom E, Carpenter MW, Ramin SM, Casey B, et al. A multicenter, randomized trial of treatment for mild gestational diabetes. N Engl J Med. 2009;361:1339–48.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Barquiel B, Herranz L, Grande C, Castro-Dufourny I, Llaro M, Parra P, et al. Body weight, weight gain and hyperglycaemia are associated with hypertensive disorders of pregnancy in women with gestational diabetes. Diabetes Metab. 2014;40:204–10.

    Article  CAS  PubMed  Google Scholar 

  8. Pallardo LF, Bartha JL, Herranz L, editors. Diabetes y embarazo. 4th ed. Barcelona: EdikaMed; 2015 (Spanish).

    Google Scholar 

  9. Acién Álvarez P. Tratado de Obstetricia y Ginecología. Obstetricia. Alicante (Spain): Molloy Editors; 1998 (Spanish).

    Google Scholar 

  10. Duckitt K, Harrington D. Risk factors for pre-eclampsia at antenatal booking: systematic review of controlled studies. BMJ. 2005;330:565.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Ricart W, López J, Mozas J, Pericot A, Sancho MA, González N, et al. Body mass index has a greater impact on pregnancy outcomes than gestational hyperglycaemia. Diabetologia. 2005;48:1736–42.

    Article  CAS  PubMed  Google Scholar 

  12. Scifres C, Feghali M, Althouse AD, Caritis S, Catov J. Adverse outcomes and potential targets for intervention in gestational diabetes and obesity. Obstet Gynecol. 2015;126:316–25.

    Article  CAS  PubMed  Google Scholar 

  13. Bellamy L, Casas J-P, Hingorani AD, Williams DJ. Pre-eclampsia and risk of cardiovascular disease and cancer in later life: systematic review and meta-analysis. BMJ. 2007;335:974.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Berks D, Hoedjes M, Raat H, Duvekot JJ, Steegers EAP, Habbema JDF. Risk of cardiovascular disease after pre-eclampsia and the effect of lifestyle interventions: a literature-based study. BJOG. 2013;120:924–31.

    Article  CAS  PubMed  Google Scholar 

  15. Hypertension in Pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. Obstet Gynecol 2013;122:1122–31.

    Google Scholar 

  16. Weissgerber TL, Mudd LM. Preeclampsia and diabetes. Curr Diab Rep. 2015;15:9.

    Article  PubMed  Google Scholar 

  17. Roberts R. Hypertension in women with gestational diabetes. Diabetes Care. 1998;21(Suppl 2):B27–32.

    PubMed  Google Scholar 

  18. Vambergue A, Nuttens MC, Goeusse P, Biausque S, Lepeut M, Fontaine P. Pregnancy induced hypertension in women with gestational carbohydrate intolerance: the diagest study. Eur J Obstet Gynecol Reprod Biol. 2002;102:31–5.

    Article  CAS  PubMed  Google Scholar 

  19. Fisher SJ. Why is placentation abnormal in preeclampsia? Am J Obstet Gynecol. 2015;213:S115–22.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Goel A, Maski MR, Bajracharya S, Wenger JB, Zhang D, Salahuddin S, et al. Epidemiology and mechanisms of De Novo and persistent hypertension in the postpartum period. Circulation. 2015;132:1726–33.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Catalano PM, McIntyre HD, Cruickshank JK, McCance DR, Dyer AR, Metzger BE, et al. The hyperglycemia and adverse pregnancy outcome study: associations of GDM and obesity with pregnancy outcomes. Diabetes Care. 2012;35:780–6.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. American College of Obstetricians and Gynecologists. Committee Opinion No. 638: First-Trimester Risk Assessment for Early-Onset Preeclampsia. Obstet Gynecol 2015;126:e25–7.

    Google Scholar 

  23. Duley L, Henderson-Smart DJ, Meher S, King JF. Antiplatelet agents for preventing pre-eclampsia and its complications. Cochrane Database Syst Rev 2007;CD004659.

    Google Scholar 

  24. Hofmeyr GJ, Lawrie TA, Atallah AN, Duley L. Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems. Cochrane Database Syst Rev 2010;CD001059.

    Google Scholar 

  25. Stout MJ, Conner SN, Colditz GA, Macones GA, Tuuli MG. The utility of 12-hour urine collection for the diagnosis of preeclampsia: a systematic review and meta-analysis. Obstet Gynecol. 2015;126:731–6.

    Article  PubMed  Google Scholar 

  26. Rasmussen KM, Catalano PM, Yaktine AL. New guidelines for weight gain during pregnancy: what obstetrician/gynecologists should know. Curr Opin Obstet Gynecol. 2009;21:521–6.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Harper LM, Tita A, Biggio JR. The institute of medicine guidelines for gestational weight gain after a diagnosis of gestational diabetes and pregnancy outcomes. Am J Perinatol. 2015;32:239–46.

    PubMed  Google Scholar 

  28. Homko C, Sivan E, Chen X, Reece EA, Boden G. Insulin secretion during and after pregnancy in patients with gestational diabetes mellitus. J Clin Endocrinol Metab. 2001;86:568–73.

    CAS  PubMed  Google Scholar 

  29. Kautzky-Willer A, Prager R, Waldhausl W, Pacini G, Thomaseth K, Wagner OF, et al. Pronounced insulin resistance and inadequate beta-cell secretion characterize lean gestational diabetes during and after pregnancy. Diabetes Care. 1997;20:1717–23.

    Article  CAS  PubMed  Google Scholar 

  30. Barquiel B, Herranz L, Hillman N, Burgos MÁ, Pallardo LF. Prepregnancy body mass index and prenatal fasting glucose are effective predictors of early postpartum metabolic syndrome in Spanish mothers with gestational diabetes. Metab Syndr Relat Disord. 2014;12:457–63.

    Article  CAS  PubMed  Google Scholar 

  31. Magnussen EB, Vatten LJ, Smith GD, Romundstad PR. Hypertensive disorders in pregnancy and subsequently measured cardiovascular risk factors. Obstet Gynecol. 2009;114:961–70.

    Article  PubMed  Google Scholar 

  32. Garovic VD, Bailey KR, Boerwinkle E, Hunt SC, Weder AB, Curb D, et al. Hypertension in pregnancy as a risk factor for cardiovascular disease later in life. J Hypertens. 2010;28:826–33.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Shopen N, Schiff E, Koren-Morag N, Grossman E. Factors that predict the development of hypertension in women with pregnancy-induced hypertension. Am J Hypertens. 2016;29:141–6.

    Article  PubMed  Google Scholar 

  34. Heida KY, Franx A, van Rijn BB, Eijkemans MJC, Boer JMA, Verschuren MWM, et al. Earlier age of onset of chronic hypertension and type 2 diabetes mellitus after a hypertensive disorder of pregnancy or gestational diabetes mellitus. Hypertension. 2015;66:1116–22.

    CAS  PubMed  Google Scholar 

  35. Engeland A, Bjørge T, Daltveit AK, Skurtveit S, Vangen S, Vollset SE, et al. Risk of diabetes after gestational diabetes and preeclampsia. A registry-based study of 230,000 women in Norway. Eur J Epidemiol. 2011;26:157–63.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Feig DS, Shah BR, Lipscombe LL, Wu CF, Ray JG, Lowe J, et al. Preeclampsia as a risk factor for diabetes: a population-based cohort study. PLoS Med. 2013;10:e1001425.

    Article  PubMed  PubMed Central  Google Scholar 

  37. American Diabetes Association. Management of diabetes in pregnancy. Diabetes Care. 2015;39:S94–8.

    Google Scholar 

  38. Mosca L, Benjamin EJ, Berra K, Bezanson JL, Dolor RJ, Lloyd-Jones DM, et al. Effectiveness-based guidelines for the prevention of cardiovascular disease in women–2011 update: a guideline from the american heart association. Circulation. 2011;123:1243–62.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Aroda VR, Christophi CA, Edelstein SL, Zhang P, Herman WH, Barrett-Connor E, et al. The effect of lifestyle intervention and metformin on preventing or delaying diabetes among women with and without gestational diabetes: the Diabetes Prevention Program outcomes study 10-year follow-up. J Clin Endocrinol Metab. 2015;100:1646–53.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Allen R, Rogozinska E, Sivarajasingam P, Khan KS, Thangaratinam S. Effect of diet- and lifestyle-based metabolic risk-modifying interventions on preeclampsia: a meta-analysis. Acta Obstet Gynecol Scand. 2014;93:973–85.

    Article  PubMed  Google Scholar 

  41. Østbye T, Krause KM, Swamy GK, Lovelady CA. Effect of breastfeeding on weight retention from one pregnancy to the next: results from the North Carolina WIC program. Prev Med (Baltim). 2010;51:368–72.

    Article  Google Scholar 

  42. Countouris ME, Schwarz EB, Rossiter BC, Althouse AD, Berlacher KL, Jeyabalan A, et al. Effects of lactation on postpartum blood pressure among women with gestational hypertension and preeclampsia. Am J Obstet Gynecol 2016.

    Google Scholar 

  43. Pérez-Ferre N, Del Valle L, Torrejón MJ, Barca I, Calvo MI, Matía P, et al. Diabetes mellitus and abnormal glucose tolerance development after gestational diabetes: a three-year, prospective, randomized, clinical-based, Mediterranean lifestyle interventional study with parallel groups. Clin Nutr. 2015;34:579–85.

    Article  PubMed  Google Scholar 

  44. American Diabetes Association. Prevention or delay of type 2 diabetes. Diabetes Care. 2015;39:S36–8.

    Google Scholar 

  45. Ferrazzani S, De Carolis S, Pomini F, Testa AC, Mastromarino C, Caruso A. The duration of hypertension in the puerperium of preeclamptic women: relationship with renal impairment and week of delivery. Am J Obstet Gynecol. 1994;171:506–12.

    Article  CAS  PubMed  Google Scholar 

  46. Makris A, Thornton C, Hennessy A. Postpartum hypertension and nonsteroidal analgesia. Am J Obstet Gynecol. 2004;190:577–8.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Diabetes Unit and Endocrinology Department, La Paz University Hospital, Paseo de la Castellana 261, 28046, Madrid, Spain

    Beatriz Barquiel & Paola Parra

Authors
  1. Beatriz Barquiel
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Paola Parra
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Beatriz Barquiel .

Editor information

Editors and Affiliations

  1. Department of Nutrition, King’s College London, London, United Kingdom

    Rajkumar Rajendram

  2. Department of Nutrition, King’s College London, London, United Kingdom

    Victor R. Preedy

  3. Department of Biomedical Sciences, University of Westminster, London, United Kingdom

    Vinood B. Patel

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this chapter

Cite this chapter

Barquiel, B., Parra, P. (2018). Hypertensive Disorders of Pregnancy in Gestational Diabetes. In: Rajendram, R., Preedy, V., Patel, V. (eds) Nutrition and Diet in Maternal Diabetes. Nutrition and Health. Humana Press, Cham. https://doi.org/10.1007/978-3-319-56440-1_15

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-56440-1_15

  • Published:

  • Publisher Name: Humana Press, Cham

  • Print ISBN: 978-3-319-56438-8

  • Online ISBN: 978-3-319-56440-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation