Maternal overweight and obesity and risk of pre-eclampsia in women with type 1 diabetes or type 2 diabetes

Diabetologia. 2016 Oct;59(10):2099-105. doi: 10.1007/s00125-016-4035-z. Epub 2016 Jul 1.

Abstract

Aims/hypothesis: Women with type 1 or type 2 diabetes are at increased risk of pre-eclampsia. Overweight and obesity are associated with an increased risk of pre-eclampsia in women without diabetes. The aim of the study was to investigate the impact of maternal overweight and obesity on the risk of pre-eclampsia in women with type 1 diabetes or type 2 diabetes.

Methods: In a population-based cohort study including singleton births in Sweden, we estimated the risk of pre-eclampsia among women with type 1 diabetes (n = 7062) and type 2 diabetes (n = 886), and investigated whether maternal overweight (BMI 25-29.9 kg/m(2)) and obesity (BMI ≥30.0 kg/m(2)) modified the risk. Logistic regression analyses were used to estimate crude and adjusted ORs with 95% CIs, using women without diabetes as the reference group (n = 1,509,525).

Results: Compared with women without diabetes, the adjusted ORs for pre-eclampsia in women with type 1 and type 2 diabetes were 5.74 (95% CI 5.31, 6.20) and 2.11 (95% CI 1.65, 2.70), respectively. The corresponding risks of pre-eclampsia combined with preterm birth were even higher. Risks of pre-eclampsia increased with maternal overweight (BMI 25-29.9 kg/m(2)) and obesity (BMI ≥30.0 kg/m(2)), foremost in women without diabetes, to a lesser extent in women with type 1 diabetes but not in women with type 2 diabetes.

Conclusions/interpretation: Maternal overweight and obesity increased risks of pre-eclampsia in women with type 1 diabetes but not in women with type 2 diabetes. Even so, considering associations between maternal BMI and overall maternal and offspring risk, all women (with and without diabetes) should aim for a normal weight before pregnancy.

Keywords: BMI; Diabetes type 1; Diabetes type 2; Moderate pre-eclampsia; Obesity; Overweight; Pre-eclampsia; Risk of pre-eclampsia; Severe pre-eclampsia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Factors
  • Body Mass Index
  • Diabetes Mellitus, Type 1 / complications*
  • Diabetes Mellitus, Type 1 / epidemiology
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / epidemiology
  • Female
  • Humans
  • Obesity / complications*
  • Obesity / epidemiology
  • Overweight / complications*
  • Overweight / epidemiology
  • Pre-Eclampsia / epidemiology
  • Pre-Eclampsia / etiology*
  • Pregnancy
  • Risk Factors
  • Sweden
  • Young Adult