Review of Prediabetes and Hypertensive Disorders of Pregnancy
| Autor: | Weiwei He, Ronee E. Wilson, Ronald R. Magness, Krystal Bullers, Chinedu Nwabuobi, Nicholas W. Carris, Judette Louis |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
030204 cardiovascular system & hematology Article law.invention Prediabetic State 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Pregnancy Diabetes mellitus Internal medicine medicine Humans Prediabetes Obesity Exercise Randomized Controlled Trials as Topic Glycated Hemoglobin 030219 obstetrics & reproductive medicine business.industry Blood Glucose Self-Monitoring Obstetrics and Gynecology Retrospective cohort study Hypertension Pregnancy-Induced medicine.disease Metformin Gestational diabetes Pediatrics Perinatology and Child Health Observational study Female business medicine.drug Diet Therapy |
| Zdroj: | Am J Perinatol |
| ISSN: | 1098-8785 |
| Popis: | Obesity and diabetes increase hypertensive disorders of pregnancy (HDP) risk, thus preventive interventions are heavily studied. How pregestational prediabetes and related interventions impact HDP risk is less characterized. Therefore, we searched and reviewed the literature to assess the impact on HDP risk of prediabetes and varied interventions. We identified 297 citations related to pregnancy, prediabetes, and early pregnancy interventions. We also reviewed the references and citations of included articles. We included five studies assessing HDP outcomes in women with first trimester hemoglobin A1c in the prediabetes range (5.7–6.4%). One prospective observational study demonstrated first trimester hemoglobin A1c (5.9–6.4%) is associated with increased HDP risk, while another prospective observational study and one retrospective observational study had similar trends without statistical significance. A small and underpowered randomized controlled trial demonstrated initiating gestational diabetes mellitus treatment (i.e., diet, monitoring, ± insulin) in response to first trimester hemoglobin A1c (5.7–6.4%) did not statistically reduce HDP compared with standard care. One retrospective observational study suggested metformin, when started early, may reduce HDP risk in patients with prediabetes. Pregestational prediabetes appears to increase HDP risk. Interventions (i.e., metformin, diet/glucose monitoring, and/or exercise) to reduce HDP risk require additional study with long-term follow-up. |
| Databáze: | OpenAIRE |
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