Hypertension and Preeclampsia in Pregnancy Complicated by Diabetes

Hypertensive disorders are one of the most common disorders that affect pregnant women. Preeclampsia (PE) complicates 4-6% of all pregnancies and is a leading cause of maternal and neonatal morbidity and mortality. Both pregestational and gestational diabetes have a significant impact on the placentation process and contribute to an increased risk in developing PE and obstetric complications. The most significant clinical risk factors for PE in gestational diabetes mellitus (GDM) patients are first trimester obesity, excessive gestational weight gain, GDM diagnosis prior to 20 weeks' gestation, poor glycemic control in the third trimester, and severity of fasting hyperglycemia at the time of OGTT. In pregnancy complicated by type 1 diabetes, the highest rate of PE occurred in women with a longer duration of diabetes, microvascular complications, chronic hypertension, and poor glycemic control during pregnancy. PE is recognized as a risk factor for cardiovascular disease and stroke, and several studies have shown that it is also a risk factor for future diabetes; women with pregestational diabetes who develop PE are also at risk for diabetic complications later in life. (c) 2020 S. Karger AG, Basel