Volume 202, Issue 3 , Pages 255.e1-255.e7, March 2010
Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study: preeclampsia
Objective
The purpose of this study was to examine associations of fasting C-peptide, body mass index (BMI), and maternal glucose with the risk of preeclampsia in a multicenter multinational study.
Study Design
We conducted a secondary analysis of a blinded observational cohort study. Subjects underwent a 75-g oral glucose tolerance test at 24-32 weeks' gestation. Associations of preeclampsia with fasting C-peptide, BMI, and maternal glucose were assessed with the use of multiple logistic regression analyses and adjustment for potential confounders.
Results
Of 21,364 women who were included in the analyses, 5.2% had preeclampsia. Adjusted odds ratios for preeclampsia for 1 SD higher fasting C-peptide (0.87 ug/L), BMI (5.1 kg/m2), and fasting (6.9 mg/dL), 1-hour (30.9 mg/dL), and 2-hour plasma glucose (23.5 mg/dL) were 1.28 (95% confidence interval [CI], 1.20–1.36), 1.60 (95% CI, 1.60–1.71), 1.08 (95% CI, 1.00–1.16), 1.19 (95% CI, 1.11–1.28), and 1.21 (95% CI,1.13–1.30), respectively.
Conclusion
Results indicate strong, independent associations of fasting C-peptide and BMI with preeclampsia. Maternal glucose levels (below diabetes mellitus) had weaker associations with preeclampsia, particularly after adjustment for fasting C-peptide and BMI.
Key words: BMI, C-peptide, glucose, preeclampsia
Supported by from the National Institute of Child Health and Human Development and the National Institute of Diabetes, Digestive, and Kidney Diseases (Grants R01-HD34242 and R01-HD34243); the National Center for Research Resources (M01-RR00048, M01-RR00080); the American Diabetes Association; Diabetes UK (RD04/0002756); Kaiser Permanente Medical Center; KK Women's and Children's Hospital; Mater Mother's Hospital; Novo Nordisk; the Myre Sim Fund of the Royal College of Physicians of Edinburgh, and the Howard and Carol Bernick Family Foundation.
The Writing Group takes responsibility for the content of this article. Members of the HAPO Study Cooperative Research Group are listed in the appendix of: HAPO Study Cooperative Research Group. Hyperglycemia and Adverse Pregnancy Outcomes. N Engl J Med 2008;358:1991-2002.
Cite this article as: The Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study Cooperative Research Group. Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study: preeclampsia. Am J Obstet Gynecol 2010;202:255.e1-7.
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Reprints: Boyd E. Metzger, MD, Northwestern University Feinberg School of Medicine, Endocrinology, 645 N Michigan Ave., Suite 530-22, Chicago, IL 60611.
From the members of the Writing Group [Division of Maternal-Fetal Medicine, Rabin Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Petah-Tiqva, Israel (Drs Yogev, Chen, and Hod); the Department of Obstetrics and Gynecology, Women and Infants Hospital of Rhode Island, Alpert Medical School of Brown University, Providence, RI (Dr Coustan); the Diabetes Service, Royal Women's Hospital, Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, VIC, Australia (Dr Oats); the Department of Endocrinology and Obstetric Medicine, Mater Health Services and Mater Clinical School of Medicine, University of Queensland, Brisbane, QLD, Australia (Dr McIntyre); the Division of Endocrinology, Department of Medicine (Dr Metzger), the Department of Preventive Medicine (Drs Lowe and Dyer), and the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology (Dr Dooley), Northwestern University Feinberg School of Medicine, Chicago, IL; the Diabetes Research Group, Queen's University Belfast (Dr Trimble), the Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital (Dr McCance), and the Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, and Royal Jubilee Maternity Hospital and Queen's University Belfast (Dr Hadden), Belfast, UK; the Department of Women and Child Health, Karolinska Institute, Stockholm, Sweden (Dr Persson); and the Department of Obstetrics and Gynaecology, Chinese University of Hong Kong, Hong Kong, People's Republic of China (Dr Rogers)].
PII: S0002-9378(10)00035-9
doi:10.1016/j.ajog.2010.01.024
© 2010 Mosby, Inc. All rights reserved.
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Latest research from the 2010 meeting of the Society for Maternal-Fetal Medicine
Volume 202, Issue 3 , Pages 255.e1-255.e7, March 2010
