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01-03-2017 | Original Article

Hypertensive disorders during pregnancy and risk of type 2 diabetes in later life: a systematic review and meta-analysis

Authors: Zengfang Wang, Zengyan Wang, Luang Wang, Mingyue Qiu, Yangang Wang, Xu Hou, Zhong Guo, Bin Wang

Published in: Endocrine | Issue 3/2017

Abstract

Many studies assessed the association between hypertensive disorders during pregnancy and risk of type 2 diabetes mellitus in later life, but contradictory findings were reported. A systemic review and meta-analysis was carried out to elucidate type 2 diabetes mellitus risk in women with hypertensive disorders during pregnancy. Pubmed, Embase, and Web of Science were searched for cohort or case-control studies on the association between hypertensive disorders during pregnancy and subsequent type 2 diabetes mellitus. Random-effect model was used to pool risk estimates. Bayesian meta-analysis was carried out to further estimate the type 2 diabetes mellitus risk associated with hypertensive disorders during pregnancy. Seventeen cohort or prospective matched case-control studies were finally included. Those 17 studies involved 2,984,634 women and 46,732 type 2 diabetes mellitus cases. Overall, hypertensive disorders during pregnancy were significantly correlated with type 2 diabetes mellitus risk (relative risk = 1.56, 95 % confidence interval 1.21–2.01, P = 0.001). Preeclampsia was significantly and independently correlated with type 2 diabetes mellitus risk (relative risk = 2.25, 95 % confidence interval 1.73–2.90, P < 0.001). In addition, gestational hypertension was also significantly and independently correlated with subsequent type 2 diabetes mellitus risk (relative risk = 2.06, 95 % confidence interval 1.57–2.69, P < 0.001). The pooled estimates were not significantly altered in the subgroup analyses of studies on preeclampsia or gestational hypertension. Bayesian meta-analysis showed the relative risks of type 2 diabetes mellitus risk for individuals with hypertensive disorders during pregnancy, preeclampsia, and gestational hypertension were 1.59 (95 % credibility interval: 1.11–2.32), 2.27 (95 % credibility interval: 1.67–2.97), and 2.06 (95 % credibility interval: 1.41–2.84), respectively. Publication bias was not evident in the meta-analysis. Preeclampsia and gestational hypertension are independently associated with substantially elevated risk of type 2 diabetes mellitus in later life.

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Title: Hypertensive disorders during pregnancy and risk of type 2 diabetes in later life: a systematic review and meta-analysis
Authors: Zengfang Wang
Zengyan Wang
Luang Wang
Mingyue Qiu
Yangang Wang
Xu Hou
Zhong Guo
Bin Wang
Publication date: 01-03-2017
Publisher: Springer US
Published in: Endocrine / Issue 3/2017
Print ISSN: 1355-008X
Electronic ISSN: 1559-0100
DOI: https://doi.org/10.1007/s12020-016-1075-6

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