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Pre-eclampsia is associated with a twofold increase in diabetes: a systematic review and meta-analysis.


ABSTRACT:

Aims/hypothesis

Pre-eclampsia is a pregnancy-specific multisystem disorder and a state of physiological insulin resistance. Our aim was to systematically evaluate and quantify the evidence on the relationship between pre-eclampsia and the future risk of diabetes.

Methods

We conducted a systematic review and meta-analysis of studies that evaluated diabetes in women with and without pre-eclampsia. We performed a systematic search of MEDLINE and EMBASE to identify relevant studies. Independent double data extractions were conducted by four reviewers. Random-effects meta-analysis was used to estimate the risk of future diabetes following pre-eclampsia.

Results

A total of 21 studies were identified with more than 2.8 million women, including more than 72,500 women with pre-eclampsia. Meta-analysis of studies that adjusted for potential confounders demonstrated that pre-eclampsia was independently associated with an increased risk of future diabetes (RR 2.37 [95% CI 1.89, 2.97]). This risk appeared in studies that followed women from less than 1 year postpartum (RR 1.97 [95% CI 1.35, 2.87]) and persisted to more than 10 years postpartum (RR 1.95 [95% CI 1.28, 2.97]). After adjusting for BMI or gestational diabetes, pre-eclampsia remained linked with an increased risk of future diabetes (RR 2.38 [95% CI 1.74, 3.24] and RR 2.36 [95% CI 1.94, 2.88], respectively).

Conclusions/interpretation

Pre-eclampsia is independently associated with a twofold increase in future diabetes. Our study highlights the importance of clinical risk assessment for the future development of diabetes in women with pre-eclampsia. We recommend detailed evaluation of a screening programme for diabetes in this high-risk population.

SUBMITTER: Wu P 

PROVIDER: S-EPMC6518071 | biostudies-literature | 2016 Dec

REPOSITORIES: biostudies-literature

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Publications

Pre-eclampsia is associated with a twofold increase in diabetes: a systematic review and meta-analysis.

Wu Pensee P   Kwok Chun Shing CS   Haththotuwa Randula R   Kotronias Rafail A RA   Babu Aswin A   Fryer Anthony A AA   Myint Phyo K PK   Chew-Graham Carolyn A CA   Mamas Mamas A MA  

Diabetologia 20160919 12


<h4>Aims/hypothesis</h4>Pre-eclampsia is a pregnancy-specific multisystem disorder and a state of physiological insulin resistance. Our aim was to systematically evaluate and quantify the evidence on the relationship between pre-eclampsia and the future risk of diabetes.<h4>Methods</h4>We conducted a systematic review and meta-analysis of studies that evaluated diabetes in women with and without pre-eclampsia. We performed a systematic search of MEDLINE and EMBASE to identify relevant studies. I  ...[more]

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