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Diabetologia. 2000 Dec;43(12):1534-9.

Glycaemic control is associated with pre-eclampsia but not with pregnancy-induced hypertension in women with type I diabetes mellitus.

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Department of Obstetrics and Gynaecology, Helsinki University Central Hospital, Helsinki, Finland.



To investigate the association between glycaemic control and hypertensive pregnancy complications.


From 1988 to 1997, we followed up 683 consecutive non-selected pregnancies in women with Type I (insulin-dependent) diabetes mellitus. Glycaemic control was assessed by assay of HbA1c. Pre-eclampsia was defined as diastolic blood pressure of 90 mmHg or more at the end of pregnancy after an increase of 15 mmHg or more, combined with proteinuria of 0.3 g or more for 24 h. Pregnancy-induced hypertension was defined similarly but without proteinuria. The same criteria were applied to a control group of 854 non-selected non-diabetic women.


Pre-eclampsia developed in 12.8% of the women with diabetes (excluding those with nephropathy before pregnancy) and in 2.7% of the control women (odds ratio 5.2; 95% CI 3.3-8.4). In multiple logistic regression, glycaemic control, nulliparity, retinopathy and duration of diabetes emerged as statistically significant independent predictors of pre-eclampsia. The adjusted odds ratios for pre-eclampsia were 1.6 (95% CI 1.3-2.0) for each 1% increment in the HbA1c value at 4-14 (median 7) weeks of gestation and 0.6 (0.5-0.8) for each 1% decrement achieved during the first half of pregnancy. Changes in glycaemic control during the second half of pregnancy did not significantly alter the risk of pre-eclampsia. Unlike pre-eclampsia, the risk of pregnancy-induced hypertension was not associated with glycaemic control.


In women with Type I diabetes, poor glycaemic control is associated with an increased risk of pre-eclampsia but not with a risk of pregnancy-induced hypertension.

[Indexed for MEDLINE]

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