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Diabetologia. 2016 Dec;59(12):2518-2526. Epub 2016 Sep 19.

Pre-eclampsia is associated with a twofold increase in diabetes: a systematic review and meta-analysis.

Author information

1
Institute for Science and Technology in Medicine, Keele University, Guy Hilton Research Centre, Thornburrow Drive, Hartshill, Stoke-on-Trent, ST4 7QB, UK. p.wu@keele.ac.uk.
2
Academic Obstetrics and Gynaecology, Maternity Centre, Royal Stoke University Hospital, Stoke-on-Trent, UK. p.wu@keele.ac.uk.
3
Keele Cardiovascular Research Group, Keele University, Stoke-on-Trent, UK.
4
The Heart Centre, Royal Stoke University Hospital, Stoke-on-Trent, UK.
5
Primary Care and Health Sciences, Keele University, Stoke-on-Trent, UK.
6
Institute for Science and Technology in Medicine, Keele University, Guy Hilton Research Centre, Thornburrow Drive, Hartshill, Stoke-on-Trent, ST4 7QB, UK.
7
Epidemiology Group, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.
8
NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) West Midlands, Keele University, Stoke-on-Trent, UK.

Abstract

AIMS/HYPOTHESIS:

Pre-eclampsia is a pregnancy-specific multisystem disorder and a state of physiological insulin resistance. Our aim was to systematically evaluate and quantify the evidence on the relationship between pre-eclampsia and the future risk of diabetes.

METHODS:

We conducted a systematic review and meta-analysis of studies that evaluated diabetes in women with and without pre-eclampsia. We performed a systematic search of MEDLINE and EMBASE to identify relevant studies. Independent double data extractions were conducted by four reviewers. Random-effects meta-analysis was used to estimate the risk of future diabetes following pre-eclampsia.

RESULTS:

A total of 21 studies were identified with more than 2.8 million women, including more than 72,500 women with pre-eclampsia. Meta-analysis of studies that adjusted for potential confounders demonstrated that pre-eclampsia was independently associated with an increased risk of future diabetes (RR 2.37 [95% CI 1.89, 2.97]). This risk appeared in studies that followed women from less than 1 year postpartum (RR 1.97 [95% CI 1.35, 2.87]) and persisted to more than 10 years postpartum (RR 1.95 [95% CI 1.28, 2.97]). After adjusting for BMI or gestational diabetes, pre-eclampsia remained linked with an increased risk of future diabetes (RR 2.38 [95% CI 1.74, 3.24] and RR 2.36 [95% CI 1.94, 2.88], respectively).

CONCLUSIONS/INTERPRETATION:

Pre-eclampsia is independently associated with a twofold increase in future diabetes. Our study highlights the importance of clinical risk assessment for the future development of diabetes in women with pre-eclampsia. We recommend detailed evaluation of a screening programme for diabetes in this high-risk population.

KEYWORDS:

Diabetes mellitus; Meta-analysis; Pre-eclampsia; Risk predictors; Screening; Systematic review

PMID:
27646865
PMCID:
PMC6518071
DOI:
10.1007/s00125-016-4098-x
[Indexed for MEDLINE]
Free PMC Article

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