Association of the comorbidity of gestational diabetes mellitus and hypertension disorders of pregnancy with birth outcomes

Xingxi Lin; Luhan Zhou; Shuting Si; Haoyue Cheng; Xialidan Alifu; Yiwen Qiu; Yan Zhuang; Ye Huang; Libi Zhang; Diliyaer Ainiwan; Hui Liu; Yunxian Yu

doi:10.3389/fendo.2024.1468820

Association of the comorbidity of gestational diabetes mellitus and hypertension disorders of pregnancy with birth outcomes

Front Endocrinol (Lausanne). 2024 Dec 12:15:1468820. doi: 10.3389/fendo.2024.1468820. eCollection 2024.

Authors

Xingxi Lin^#^{1

2}, Luhan Zhou^#^{1

2}, Shuting Si³, Haoyue Cheng^{1

2}, Xialidan Alifu^{1

2}, Yiwen Qiu^{1

2}, Yan Zhuang^{1

2}, Ye Huang^{1

2}, Libi Zhang^{1

2}, Diliyaer Ainiwan^{1

2}, Hui Liu⁴, Yunxian Yu^{1

2}

Affiliations

¹ Department of Public Health, and Department of Anesthesiology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
² Department of Epidemiology and Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, China.
³ Department of Health Care, Yiwu Maternity and Children Hospital (Yiwu Branch of Children's Hospital Zhejiang University School of Medicine), Yiwu, China.
⁴ Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.

^# Contributed equally.

Abstract

Backgrounds: Many pregnant women suffer from more than one pregnancy complication. However, whether those women experienced a higher risk of adverse birth outcomes is unclear. This study aims to assess the association between the comorbidity of gestational diabetes mellitus (GDM) and hypertension disorders of pregnancy (HDP) and adverse birth outcomes.

Methods: The data was from the Zhoushan Maternal and Child Health Hospital electronic medical recorder system (EMRS) between 2015 and 2022. Multivariate linear regression model was used to analyze the association of GDM, HDP, and comorbidity with birth weight and gestational age, respectively. Multiple logistic regression model was used to analyze the association of GDM, HDP, and comorbidity with adverse birth outcomes.

Results: 13645 pregnant women were included. GDM+HDP was significantly associated with a higher risk of composite adverse neonatal outcomes (OR=1.82, 95%CI: 1.02-3.04), including preterm birth, placenta previa, and/or neonatal jaundice, a higher risk of small for gestational age (SGA) (OR=2.2, 95% CI: 1.24 3.92) and large for gestational age (LGA) (OR=2.33, 95% CI: 1.64 3.31) compared with the normal group. Further analysis showed that HDP diagnosed in the 21-27^th week comorbid with GDM had the lowest gestational age at delivery (β= -1.57, P=0.0002) and birth weight (β= -189.57, P=0.0138). Moreover, combined hyperglycemia (CH) comorbid with HDP had the strongest association with reduced gestational age (β= -0.83, P=0.0021).

Conclusion: Pregnant women suffering from both GDM and HDP had a higher risk of adverse neonatal outcomes; hence, the prevent and treatment of GDM and HDP, especially their comorbidity, are very important for pregnant women.

Keywords: adverse neonatal outcomes; comorbidity; gestational diabetes mellitus; hypertension disorders; pregnancy.

MeSH terms

Adult
Birth Weight
China / epidemiology
Comorbidity*
Diabetes, Gestational* / epidemiology
Female
Gestational Age
Humans
Hypertension, Pregnancy-Induced* / epidemiology
Infant, Newborn
Pregnancy
Pregnancy Outcome* / epidemiology
Premature Birth / epidemiology
Retrospective Studies

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This work was supported by 4+X Clinical Research Project of Women's Hospital, School of Medicine, Zhejiang University, and the National Key R&D Program of China [grant number 2022YFC2703505 and 2021YFC2701901].