Considering parents as a unit: Associations of gestational diabetes and gestational hypertension with postpartum diabetes and hypertension in couples.

OBJECTIVES

To evaluate the associations of a combined indicator of gestational diabetes mellitus (GDM) and gestational hypertension (GH) with diabetes and with hypertension in parental couples as a 'unit'.

STUDY DESIGN

Utilizing administrative health data, GH was identified in matched pairs (GDM vs. no GDM) of mothers with singleton live births (Quebec, Canada; cohort inception 1990-2007). Couples were categorized based on GDM/GH status s ('neither'; 'either'; or 'both'). Using validated administrative health database definitions, associations of this indicator with diabetes and with hypertension in both members of the couple (12 weeks postpartum to March 31, 2012) were evaluated through adjusted Cox proportional hazard models.

RESULTS

In 63,438 couples over a mean of 12.8 years (SD 5.4), diabetes risk was 9-fold higher (HR: 8.9; 95% CI 6.4, 12.2) in couples with either GDM/GH and 16-fold higher (HR 16.0; 95% CI 10.9, 23.5) in couples with both conditions compared to those with neither. Hypertension risk was 2-fold higher (HR: 1.8; 95% CI 1.5, 2.0) in couples either GDM/GH and 6-fold higher (HR 5.8; 95% CI 4.9, 7.0) in couples with both conditions compared to those with neither condition.

CONCLUSIONS

GDM/GH predict diabetes and hypertension in couples as a unit underscoring the concept of shared couple risk. These findings may help foster couple collaboration for cardiovascular risk reduction in the household.