Shih Yu-Hsiang, Yang Chiao-Yu, Lung Chia-Chi
Department of Obstetrics and Gynecology, Taichung Veterans General Hospital, Taichung City 40705, Taiwan.
Department of Public Health, Chung Shan Medical University, Taichung City 40201, Taiwan.
World J Diabetes. 2025 Jun 15;16(6):105080. doi: 10.4239/wjd.v16.i6.105080.
The impact of varying degrees of pregnancy-induced hypertension (PIH) on the risk of developing diabetes later in life is currently unknown.
To assess the long-term risks of type 2 diabetes mellitus (T2DM), prediabetes, and mortality that are associated with hypertensive disorders of pregnancy.
This retrospective cohort study used the TriNetX United States Collaborative Network to examine outcomes, especially T2DM, prediabetes and mortality, related to hypertensive disorders of pregnancy in females aged 21-45. Participants had no history of hypertension or diabetes before pregnancy or before 20 weeks of gestation. Propensity score matching was applied to balance covariates such as gestational diabetes, polycystic ovarian syndrome, chronic kidney disease, hyperlipidemia, overweight/obesity, nicotine dependence, alcohol abuse, and healthcare utilization. This ensured comparability between groups and reduced potential confounding in outcome evaluation.
This study included 318544 females aged 21-45 with and without PIH. Females with PIH had higher risks of T2DM [hazard ratio (HR): 1.907, 95% confidence interval (CI): 1.821-1.998), prediabetes (HR: 1.610, 95%CI: 1.537-1.687), and mortality (HR: 1.501, 95%CI: 1.361-1.655) over a follow-up of up to 18 years. Incidence rates for T2DM, prediabetes, and mortality were 3.2%, 2.7%, and 0.6%, respectively. Subgroup analyses showed that the presence of gestational hypertension, preeclampsia, and eclampsia increased risks across all outcomes. Persistent hypertension beyond 12 weeks postpartum was linked to more than a 3-fold increase in mortality. Preventative aspirin use during pregnancy did not reduce the risks of T2DM, prediabetes, or mortality among those with PIH.
PIH significantly increases the long-term risks of T2DM, prediabetes, and mortality, highlighting the urgent need for improved long-term management strategies to enhance overall health in such individuals.
不同程度的妊娠高血压综合征（PIH）对日后患糖尿病风险的影响目前尚不清楚。
评估妊娠高血压疾病与2型糖尿病（T2DM）、糖尿病前期及死亡的长期风险。
这项回顾性队列研究利用TriNetX美国协作网络，调查21至45岁女性妊娠高血压疾病相关的结局，尤其是T2DM、糖尿病前期及死亡情况。参与者在妊娠前或妊娠20周前无高血压或糖尿病病史。采用倾向评分匹配法平衡协变量，如妊娠期糖尿病、多囊卵巢综合征、慢性肾病、高脂血症、超重/肥胖、尼古丁依赖、酒精滥用及医疗保健利用情况。这确保了组间的可比性，并减少了结局评估中的潜在混杂因素。
本研究纳入了318544名21至45岁患有和未患有PIH的女性。在长达18年的随访中，患有PIH的女性患T2DM的风险更高[风险比（HR）：1.907，95%置信区间（CI）：1.821 - 1.998]、糖尿病前期（HR：1.610，95%CI：1.537 - 1.687）及死亡（HR：1.501，95%CI：1.361 - 1.655）。T2DM、糖尿病前期及死亡的发病率分别为3.2%、2.7%和0.6%。亚组分析表明，妊娠期高血压、先兆子痫和子痫的存在会增加所有结局的风险。产后12周后持续高血压与死亡率增加3倍以上有关。孕期预防性使用阿司匹林并不能降低患有PIH者患T2DM、糖尿病前期或死亡的风险。
PIH显著增加了T2DM、糖尿病前期及死亡的长期风险，凸显了迫切需要改进长期管理策略以改善此类人群的整体健康状况。
