Format

Send to

Choose Destination
Diabetes Care. 2019 Jan;42(1):44-49. doi: 10.2337/dc18-1532. Epub 2018 Nov 19.

Postpregnancy BMI in the Progression From Hypertensive Disorders of Pregnancy to Type 2 Diabetes.

Timpka S1,2,3, Stuart JJ4,2,5, Tanz LJ4,5, Hu FB2,6,7, Franks PW3,6, Rich-Edwards JW4,2,5.

Author information

1
Connors Center for Women's Health and Gender Biology, Division of Women's Health, Department of Medicine, Brigham and Women's Hospital, Boston, MA simon.timpka@med.lu.se.
2
Harvard Medical School, Boston, MA.
3
Genetic and Molecular Epidemiology Unit, Lund University Diabetes Centre, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.
4
Connors Center for Women's Health and Gender Biology, Division of Women's Health, Department of Medicine, Brigham and Women's Hospital, Boston, MA.
5
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.
6
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.
7
Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA.

Abstract

OBJECTIVE:

To study the extent to which BMI after pregnancy adds to the elevated risk of postpregnancy type 2 diabetes in women with a history of hypertensive disorders of pregnancy (HDP) (preeclampsia or gestational hypertension).

RESEARCH DESIGN AND METHODS:

We used data from the Nurses' Health Study II, a prospective cohort study. In women aged 45-54 years without prior gestational diabetes mellitus, we investigated the interaction between BMI and HDP history on the risk of type 2 diabetes. For clinical and public health relevance, we focused on additive interaction. The main outcome measure was the relative excess risk due to interaction calculated from multivariable Cox proportional hazards models using normal weight as the reference group.

RESULTS:

In total, 6,563 (11.7%) of 56,159 participants had a history of HDP and 1,341 women developed type 2 diabetes during 436,333 person-years. BMI was a strong risk factor for type 2 diabetes regardless of HDP history. However, there was evidence of an additive interaction between BMI and HDP for the risk of type 2 diabetes (P = 0.004). The attributable proportion of risk due to the interaction ranged from 0.12 (95% CI -0.22, 0.46) in women who were overweight to 0.36 (95% CI 0.13, 0.59) in women with obesity class I.

CONCLUSIONS:

Maintaining a healthy weight may be of even greater importance in women with a history of HDP, compared with other women with a history of only normotensive pregnancies, to reduce midlife risk of type 2 diabetes.

PMID:
30455328
PMCID:
PMC6300702
DOI:
10.2337/dc18-1532
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for HighWire
Loading ...
Support Center