Usefulness of blood pressure monitoring in patients with gestational diabetes mellitus

Sánchez-Lechuga, Begoña; Lara-Barea, Almudena; Córdoba-Doña, Juan Antonio; Galván, Ana Montero; Cruz, Alicia Abal; Aguilar‐Diosdado, Manuel; López-Tinoco, Cristina

doi:10.1016/j.endien.2018.07.004

Cited by 4 publications

(3 citation statements)

References 25 publications

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“…Furthermore, multivariate analysis identified nocturnal SBP as an independent risk factor for the development of HDPs, coinciding with the data published in relation to pregnant women with chronic hypertension or high-risk pregnancy [ 10 , 12 ]. In a cohort of normotensive pregnant women with GDM, we also observed that higher nocturnal SBP increased the risk of developing HDPs [ 14 ]. In addition, in this study, we found that patients in the GDM with obesity group had higher mean SBP, nocturnal SBP, and DBP than pregnant women with GDM without obesity.…”

Section: Discussionmentioning

confidence: 99%

“…In our study, the non-dipper pattern was more prevalent in the obesity groups, whereas women without obesity more frequently had a dipper circadian pattern. Although a significant relationship between the non-dipper pattern and the diagnosis of GDM in normotensive pregnant women has been described [ 14 , 37 ], these works do not analyze the influence of pre-pregnancy obesity as an independent factor in the ABPM pattern. In fact, there was a significant correlation between prepregnancy BMI and mean SBP and nocturnal SBP levels detected by ABPM ( Figure 2 ) but not with blood glucose levels.…”

Section: Discussionmentioning

confidence: 99%

“…These observations have led some authors, such as Salazar et al [ 12 , 13 ], to recommend using ABPM in high-risk pregnancies (including women with pregestational diabetes) to detect early BP profile alterations in patients who subsequently develop HDPs. In pregnant women with GDM, there is insufficient evidence, but in a previously published study, we reported that high nocturnal SBP levels increase the risk of developing HDPs in pregnant women with GDM [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

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Blood Pressure Monitoring and Perinatal Outcomes in Normotensive Women with Gestational Diabetes Mellitus

Lara-Barea

Sánchez-Lechuga

Vidal-Suárez

et al. 2022

JCM

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Alterations in ambulatory blood pressure detected by monitoring (ABPM) have been associated with perinatal complications in hypertensive pregnant women. Aim: To establish the relationships between the blood pressure (BP) profiles detected by ABPM and adverse perinatal outcomes in normotensive women with gestational diabetes mellitus (GDM). Methods: A prospective study of normotensive women in whom 24 h ABPM was performed at 28–32 weeks of pregnancy. The obstetric and perinatal outcomes were evaluated. Results: Two hundred patients were included. Thirty-seven women with GDM and obesity had significantly higher mean systolic BP (SBP) and nocturnal SBP and diastolic BP (DBP) compared to women with only GDM (n = 86). Nocturnal SBP (OR = 1.077; p = 0.015) and obesity (OR = 1.131; p = 0.035) were risk factors for the development of hypertensive disorders of pregnancy (HDPs). Mothers of newborns with neonatal complications (n = 27) had higher nocturnal SBP (103.8 vs. 100 mmHg; p = 0.047) and DBP (62.7 vs. 59.4; p = 0.016). Women who delivered preterm (n = 10) had higher BP and a non-dipper pattern (p = 0.005). Conclusions: Nocturnal SBP was a predictor of HDPs in normotensive women with obesity or GDM. Alterations in ABPM in these patients were associated with poor obstetric and perinatal outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Blood Pressure Monitoring and Perinatal Outcomes in Normotensive Women with Gestational Diabetes Mellitus

Lara-Barea

Sánchez-Lechuga

Vidal-Suárez

et al. 2022

JCM

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Expression and clinical significance of miR-204 in patients with hypertensive disorder complicating pregnancy

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2022

BMC Pregnancy Childbirth

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Objective Hypertensive disorder complicating pregnancy (HDCP) is a unique and common obstetrical complication in pregnancy. The current study sought to investigate the diagnostic value of serum miR-204 in HDCP patients. Methods A total of 196 HDCP patients were enrolled, with 54 healthy pregnant women as controls. The expression levels of miR-204 and inflammatory factors in the serum were determined. Receiver operating characteristic (ROC) curve was used to assess the diagnostic value of miR-204 in HDCP patients. Person coefficient was introduced to analyze the correlation between miR-204 and inflammatory indexes. Kaplan–Meier method was employed to analyze the effect of miR-204 expression on the incidence of adverse pregnancy outcomes. Logistic regression was adopted to assess the risk factors for adverse pregnancy outcomes. Results miR-204 expression was upregulated in the serum of HDCP patients. The serum miR-204 level > 1.432 could assist the diagnosis of HDCP. miR-204 level in the serum was positively correlated with TNF-α, IL-6, and hs-CRP concentrations in HDCP patients. The risk of adverse outcomes was higher in pregnant women with high miR-204 expression. High miR-204 expression was associated with an increased risk of adverse pregnancy outcomes after adjusting the family history of HDCP, systolic pressure, diastolic pressure, AST, ALT, LDH, 24-h urinary protein, TNF-α, IL-6, and hs-CRP. Conclusion The high expression of miR-204 assists the diagnosis of HDCP and is an independent risk factor for adverse pregnancy outcomes in HDCP patients.

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Higher daytime systolic BP, prepregnancy BMI and an elevated sFlt-1/PlGF ratio predict the development of hypertension in normotensive pregnant women

Lara-Barea

Sánchez-Lechuga

Aguilar‐Diosdado

et al. 2022

Reprod Biol Endocrinol

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Background The risk of hypertensive disorders of pregnancy (HDP) varies in women with gestational diabetes mellitus (GDM), depending on the degree of insulin resistance and is also influenced by obesity. The aim of this study was to evaluate clinical features, blood pressure (BP) profiles and inflammatory markers, to identify patients with an elevated risk of developing HDP. Methods A total of 146 normotensive pregnant women were studied. We analysed the relationships of BP profiles detected by ambulatory blood pressure monitoring (ABPM) with serum biomarkers and angiogenic factors and their association with the development of HDP. Results Fourteen (9.6%) women developed HDP, of which 11 had GDM and 8 had obesity. Women with HDP had higher values of 24-h and daytime systolic/diastolic BP (113/69 vs. 104/64; 115/72 vs. 106/66 mmHg, respectively; p < 0.05). Higher levels of leptin (10.97 ± 0.82 vs. 10.2 ± 1.11; p = 0.018) andmonocyte chemoattractant protein-1 (MCP-1) (5.24 ± 0.60 vs. 4.9 ± 0.55; p = 0.044) and a higher soluble fms-like tyrosine kinase-1/placental growth factor (sFlt-1/PlGF) ratio (4.37 ± 2.2 vs. 2.2 ± 1.43; p = 0.003) were also observed in the HDP patients. Multivariate analysis showed that a higher sFlt-1/PlGF ratio was associated with an increased risk of developing HDP [OR = 2.02; IC 95%: 1.35–3.05]. Furthermore, higher daytime systolic BP [OR = 1.27; IC 95% 1.00–1.26] and prepregnancy body mass index (BMI) [OR = 1.14; IC 95%: 1.01–1.30] significantly increased the risk of developing HDP. Conclusions Higher daytime systolic BP values, prepregnancy BMI and the sFlt-1/PlGF ratio are useful for identifying normotensive pregnant women with an increased risk of developing HDP.

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Usefulness of blood pressure monitoring in patients with gestational diabetes mellitus

Cited by 4 publications

References 25 publications

Blood Pressure Monitoring and Perinatal Outcomes in Normotensive Women with Gestational Diabetes Mellitus

Blood Pressure Monitoring and Perinatal Outcomes in Normotensive Women with Gestational Diabetes Mellitus

Expression and clinical significance of miR-204 in patients with hypertensive disorder complicating pregnancy

Higher daytime systolic BP, prepregnancy BMI and an elevated sFlt-1/PlGF ratio predict the development of hypertension in normotensive pregnant women

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