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

Journal of Human Hypertension volume 36, pages 61–68 (2022)Cite this article

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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.

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Acknowledgements

The HAPO FUS investigators are grateful for the women and children who participated in HAPO and HAPO FUS.

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’s 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.

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Authors and Affiliations

  1. Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK

    M. Maresh

  2. Kaiser Permanente Southern California, Pasadena, CA, USA

    J. M. Lawrence & D. A. Sacks

  3. Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    D. M. Scholtens, A. Kuang, L. P. Lowe, W. L. Lowe Jr, A. R. Dyer & B. E. Metzger

  4. Rajavithi Hospital, Bangkok, Thailand

    C. Deerochanawong

Authors
  1. M. Maresh
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  2. J. M. Lawrence
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  4. A. Kuang
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  10. B. E. Metzger
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Contributions

BEM, LPL, WLL, DMS, and ARD conceived and designed the study, assisted with data collection, interpreted the data, and participated in writing the manuscript. MM and WLL researched the literature. AK analyzed the data. MM acquired data, drafted the original manuscript, and participated in its revisions. JML, CD, and DS acquired data and participated in writing the manuscript. All authors approved the final manuscript as submitted.

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Correspondence to B. E. Metzger.

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Maresh, M., Lawrence, J.M., Scholtens, D.M. et al. Association of glucose metabolism and blood pressure during pregnancy with subsequent maternal blood pressure. J Hum Hypertens 36, 61–68 (2022). https://doi.org/10.1038/s41371-020-00468-2

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