Pre-eclampsia and the later development of type 2 diabetes in mothers and their children: an intergenerational study from the Walker cohort

Abstract

Aims/hypothesis Studies have shown a relationship between pre-eclampsia and later coronary artery disease. This study investigated whether there is a relationship between pre-eclampsia and the development of type 2 diabetes in mothers and their babies and how this is affected by infant birthweight. Subjects and methods This was an intergenerational cohort study. The study population comprised 7,187 mothers who gave birth and 8,648 babies who were born in Dundee, Scotland between 1952 and 1958. Their later diabetic status was defined from 1980 to 2003 by linkage to populationbased datasets.Results There were 810 (11.3%) mothers with preeclampsia and 745 (10.4%) who subsequently developed type 2 diabetes. Logistic regression showed an increased risk of developing type 2 diabetes for mothers with preeclampsia, unadjusted odds ratio (OR) 1.37 (95% CI 1.10-1.71), p=0.005. This relationship persisted after adjustment for infant birthweight, OR 1.40 (95% CI 1.12-1.75), p=0.003. Of the babies born between 1952 and 1958, 221 (2.6%) had developed type 2 diabetes, 137 of them male (2.9% of male subjects in study population) and 84 female (2.2% of female subjects). The relationship between preeclampsia in the mother and the risk of type 2 diabetes in the offspring did not reach statistical significance, OR 1.38 (95% CI 0.90-2.10). Babies with birthweight in the lowest quintile (adjusted for sex, gestation and birth order) had an increased risk of developing type 2 diabetes, OR for lowest quintile vs highest quintile 1.84 (95% CI 1.24-2.72), p=0.002. Conclusions/interpretation Pre-eclampsia is associated with increased risk of developing type 2 diabetes in the mother, but birthweight is a more important determinant of future risk for the offspring.

Trends in the use of preconditioning to hypoxia for early prevention of future life diseases

“…Preterm birth may be caused by hypoxic hypoxia (14), infection/inflammation (15,16), preeclampsia (17), or maternal psychological stress (18). Intrauterine growth restriction/retardation may be caused by hypoxic hypoxia (19), preeclampsia (20), or maternal psychological stress (21). Low weight/ height at birth may be caused by hypoxic hypoxia (22) or preeclampsia (20).…”

“…Intrauterine growth restriction/retardation may be caused by hypoxic hypoxia (19), preeclampsia (20), or maternal psychological stress (21). Low weight/ height at birth may be caused by hypoxic hypoxia (22) or preeclampsia (20). Therefore, all considered abnormalities of early growth are tightly related to some types of hypoxia.…”

RETIRED: Diagnosis, Evaluation, and Management of the Hypertensive Disorders of Pregnancy

“…As pregnancy is a biological 'stress test' of sorts, women with a prior HDP (particularly associated with preterm delivery or adverse perinatal outcome) should be informed of their increased future health risks, including; hypertension; cardiovascular and cerebrovascular morbidity and mortality; subsequent renal disease; thromboembolism; hypothyroidism; and type 2 diabetes mellitus [494][495][496][497][498][499][500][501][502][503]. It is unclear whether the microalbuminuria associated with previous preeclampsia represents underlying renal disease or is an independent cardiovascular risk marker [504].…”

A Maternally Sequestered, Biopolymer‐Stabilized Vascular Endothelial Growth Factor (VEGF) Chimera for Treatment of Preeclampsia

“…This susceptibility to cardiorenal and metabolic diseases post–index pregnancy has been attributed to the pathophysiological mechanisms10, 11 initiated by the placental ischemia. In addition to the maternal effects, preeclampsia is highly associated with intrauterine growth restriction12 and developmentally programs the increased risk for cardiovascular disease,13, 14 stroke,15 renal disease,16 and metabolic dysfunction17, 18 in the adult offspring of preeclamptic women 19. Since the resolution of preeclampsia is achieved only through parturition of the ischemic placenta,20 a difficult decision often must be made between inducing early delivery in order to halt the progression of the syndrome in the mother and risking premature birth complications to the fetus 21.…”