Association of glucose metabolism and blood pressure during pregnancy with subsequent maternal blood pressure

M. Maresh; J. M. Lawrence; D. M. Scholtens; A. Kuang; L. P. Lowe; C. Deerochanawong; D. A. Sacks; W. L. Lowe; A. R. Dyer; B. E. Metzger

doi:10.1038/s41371-020-00468-2

Association of glucose metabolism and blood pressure during pregnancy with subsequent maternal blood pressure

M. Maresh, J. M. Lawrence, D. M. Scholtens, A. Kuang, L. P. Lowe, C. Deerochanawong, D. A. Sacks, W. L. Lowe, A. R. Dyer, B. E. Metzger^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

4 Scopus citations

Abstract

The goal of this study was to examine associations of measures of maternal glucose metabolism and blood pressure during pregnancy with blood pressure at follow-up in the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) cohort. The HAPO Follow-Up Study included 4747 women who had a 75-g oral glucose tolerance test (OGTT) at ~28 weeks’ gestation. Of these, 4572 women who did not have chronic hypertension during their pregnancy or other excluding factors, had blood pressure evaluation 10–14 years after the birth of their HAPO child. Primary outcomes were systolic blood pressure (SBP), diastolic blood pressure (DBP), and hypertension (SBP ≥ 140 and/or DBP ≥ 90 or treatment for hypertension) at follow-up. Blood pressure during pregnancy was associated with all blood pressure outcomes at follow-up independent of glucose and insulin sensitivity during pregnancy. The sum of glucose z-scores was associated with blood pressure outcomes at follow-up but associations were attenuated in models that included pregnancy blood pressure measures. Associations with SBP were significant in adjusted models, while associations with DBP and hypertension were not. Insulin sensitivity during pregnancy was associated with all blood pressure outcomes at follow-up, and although attenuated after adjustments, remained statistically significant (hypertension OR 0.79, 95%CI 0.68–0.92; SBP beta −0.91, 95% CI −1.34 to −0.49; DBP beta −0.50, 95% CI −0.81 to −0.19). In conclusion, maternal glucose values at the pregnancy OGTT were not independently associated with maternal blood pressure outcomes 10–14 years postpartum; however, insulin sensitivity during pregnancy was associated independently of blood pressure, BMI, and other covariates measured during pregnancy.

Original language	English (US)
Pages (from-to)	61-68
Number of pages	8
Journal	Journal of human hypertension
Volume	36
Issue number	1
DOIs	https://doi.org/10.1038/s41371-020-00468-2
State	Published - Jan 2022

Funding

Funding The HAPO Follow-Up Study is funded by grant 1U01DK094830 from the National Institute of Diabetes, Digestive, and Kidney Diseases and the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Study data were collected and managed using REDCap electronic data capture tools hosted at Northwestern University Feinberg School of Medicine (FSM). REDCap is supported at FSM by the Northwestern University Clinical and Translational Science (NUCATS) Institute. The research reported in this publication was supported, in part, by the National Institutes of Health\u2019s National Center for Advancing Translational Sciences, grant UL1TR001422. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

ASJC Scopus subject areas

Internal Medicine

Access to Document

10.1038/s41371-020-00468-2

Cite this

@article{9c86e94d094747c688e055c6e0ba7b91,

title = "Association of glucose metabolism and blood pressure during pregnancy with subsequent maternal blood pressure",

abstract = "The goal of this study was to examine associations of measures of maternal glucose metabolism and blood pressure during pregnancy with blood pressure at follow-up in the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) cohort. The HAPO Follow-Up Study included 4747 women who had a 75-g oral glucose tolerance test (OGTT) at ~28 weeks{\textquoteright} gestation. Of these, 4572 women who did not have chronic hypertension during their pregnancy or other excluding factors, had blood pressure evaluation 10–14 years after the birth of their HAPO child. Primary outcomes were systolic blood pressure (SBP), diastolic blood pressure (DBP), and hypertension (SBP ≥ 140 and/or DBP ≥ 90 or treatment for hypertension) at follow-up. Blood pressure during pregnancy was associated with all blood pressure outcomes at follow-up independent of glucose and insulin sensitivity during pregnancy. The sum of glucose z-scores was associated with blood pressure outcomes at follow-up but associations were attenuated in models that included pregnancy blood pressure measures. Associations with SBP were significant in adjusted models, while associations with DBP and hypertension were not. Insulin sensitivity during pregnancy was associated with all blood pressure outcomes at follow-up, and although attenuated after adjustments, remained statistically significant (hypertension OR 0.79, 95%CI 0.68–0.92; SBP beta −0.91, 95% CI −1.34 to −0.49; DBP beta −0.50, 95% CI −0.81 to −0.19). In conclusion, maternal glucose values at the pregnancy OGTT were not independently associated with maternal blood pressure outcomes 10–14 years postpartum; however, insulin sensitivity during pregnancy was associated independently of blood pressure, BMI, and other covariates measured during pregnancy.",

author = "M. Maresh and Lawrence, {J. M.} and Scholtens, {D. M.} and A. Kuang and Lowe, {L. P.} and C. Deerochanawong and Sacks, {D. A.} and Lowe, {W. L.} and Dyer, {A. R.} and Metzger, {B. E.}",

note = "Publisher Copyright: {\textcopyright} 2021, The Author(s), under exclusive licence to Springer Nature Limited.",

year = "2022",

month = jan,

doi = "10.1038/s41371-020-00468-2",

language = "English (US)",

volume = "36",

pages = "61--68",

journal = "Journal of human hypertension",

issn = "0950-9240",

publisher = "Springer Nature",

number = "1",

}

TY - JOUR

T1 - Association of glucose metabolism and blood pressure during pregnancy with subsequent maternal blood pressure

AU - Maresh, M.

AU - Lawrence, J. M.

AU - Scholtens, D. M.

AU - Kuang, A.

AU - Lowe, L. P.

AU - Deerochanawong, C.

AU - Sacks, D. A.

AU - Lowe, W. L.

AU - Dyer, A. R.

AU - Metzger, B. E.

PY - 2022/1

Y1 - 2022/1

N2 - The goal of this study was to examine associations of measures of maternal glucose metabolism and blood pressure during pregnancy with blood pressure at follow-up in the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) cohort. The HAPO Follow-Up Study included 4747 women who had a 75-g oral glucose tolerance test (OGTT) at ~28 weeks’ gestation. Of these, 4572 women who did not have chronic hypertension during their pregnancy or other excluding factors, had blood pressure evaluation 10–14 years after the birth of their HAPO child. Primary outcomes were systolic blood pressure (SBP), diastolic blood pressure (DBP), and hypertension (SBP ≥ 140 and/or DBP ≥ 90 or treatment for hypertension) at follow-up. Blood pressure during pregnancy was associated with all blood pressure outcomes at follow-up independent of glucose and insulin sensitivity during pregnancy. The sum of glucose z-scores was associated with blood pressure outcomes at follow-up but associations were attenuated in models that included pregnancy blood pressure measures. Associations with SBP were significant in adjusted models, while associations with DBP and hypertension were not. Insulin sensitivity during pregnancy was associated with all blood pressure outcomes at follow-up, and although attenuated after adjustments, remained statistically significant (hypertension OR 0.79, 95%CI 0.68–0.92; SBP beta −0.91, 95% CI −1.34 to −0.49; DBP beta −0.50, 95% CI −0.81 to −0.19). In conclusion, maternal glucose values at the pregnancy OGTT were not independently associated with maternal blood pressure outcomes 10–14 years postpartum; however, insulin sensitivity during pregnancy was associated independently of blood pressure, BMI, and other covariates measured during pregnancy.

AB - The goal of this study was to examine associations of measures of maternal glucose metabolism and blood pressure during pregnancy with blood pressure at follow-up in the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) cohort. The HAPO Follow-Up Study included 4747 women who had a 75-g oral glucose tolerance test (OGTT) at ~28 weeks’ gestation. Of these, 4572 women who did not have chronic hypertension during their pregnancy or other excluding factors, had blood pressure evaluation 10–14 years after the birth of their HAPO child. Primary outcomes were systolic blood pressure (SBP), diastolic blood pressure (DBP), and hypertension (SBP ≥ 140 and/or DBP ≥ 90 or treatment for hypertension) at follow-up. Blood pressure during pregnancy was associated with all blood pressure outcomes at follow-up independent of glucose and insulin sensitivity during pregnancy. The sum of glucose z-scores was associated with blood pressure outcomes at follow-up but associations were attenuated in models that included pregnancy blood pressure measures. Associations with SBP were significant in adjusted models, while associations with DBP and hypertension were not. Insulin sensitivity during pregnancy was associated with all blood pressure outcomes at follow-up, and although attenuated after adjustments, remained statistically significant (hypertension OR 0.79, 95%CI 0.68–0.92; SBP beta −0.91, 95% CI −1.34 to −0.49; DBP beta −0.50, 95% CI −0.81 to −0.19). In conclusion, maternal glucose values at the pregnancy OGTT were not independently associated with maternal blood pressure outcomes 10–14 years postpartum; however, insulin sensitivity during pregnancy was associated independently of blood pressure, BMI, and other covariates measured during pregnancy.

UR - http://www.scopus.com/inward/record.url?scp=85100428505&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85100428505&partnerID=8YFLogxK

U2 - 10.1038/s41371-020-00468-2

DO - 10.1038/s41371-020-00468-2

M3 - Article

C2 - 33536549

AN - SCOPUS:85100428505

SN - 0950-9240

VL - 36

SP - 61

EP - 68

JO - Journal of human hypertension

JF - Journal of human hypertension

IS - 1

ER -

Association of glucose metabolism and blood pressure during pregnancy with subsequent maternal blood pressure

Abstract

Funding

ASJC Scopus subject areas

Access to Document

Other files and links

Fingerprint

Cite this