Key result
Gestational glucose intolerance linked to ~17% higher risk of incident maternal hypertension.
Why the study?
Gestational diabetes is linked to future hypertension, but whether gestational glucose intolerance—subclinical hyperglycemia in pregnancy—also increases hypertension risk remained unknown.
Is gestational glucose intolerance associated with an increased risk of incident maternal hypertension compared to normal glucose tolerance?
Cohort (n=27,029)
No
Is gestational glucose intolerance associated with an increased risk of incident maternal hypertension compared to normal glucose tolerance?
Hazard Ratio: 1.17 (95% CI 1.03–1.32)
Absolute Event Rate: 7.8% vs 5.9%
Gestational glucose intolerance, even when not meeting criteria for gestational diabetes, is associated with a significantly increased risk of future maternal hypertension.
May warrant enhanced postpartum hypertension surveillance; extends GDM link to milder intolerance but leaves causal effects open.
Introduction and Objective: Gestational diabetes (GDM) is associated with an increased risk of future hypertension (HTN). We tested if gestational glucose intolerance (GGI), subclinical hyperglycemia in pregnancy, is also associated with an increased HTN risk. Methods: This was a retrospective study in an electronic health record-based cohort of pregnancies delivered at an academic medical center (1998-2016) that were free of HTN and diabetes at baseline. We defined HTN using problem list terms and ICD codes. We defined GGI as an abnormal glucose loading test followed by an oral glucose tolerance test that did not meet GDM criteria (<2 abnormal values). We categorized deliveries as normal glucose tolerance (NGT), GGI or GDM. We fit a Cox model adjusted for time-invariant (age, race/ethnicity) and time-varying covariates (1st trimester BMI, parity, insurance, marital status, social deprivation index), updated at each delivery. Follow-up began at the first eligible delivery. Results: We analyzed 37,033 pregnancies in 27,029 individuals with median (IQR) age at delivery and BMI of 31.4 (27.2-34.8) years and 24.0 (21.7-27.3) kg/m2, respectively. During a median follow-up of 12.6 years (IQR 6.1-18.4), there were 1,934 cases (7.2%) of incident HTN. The rate of HTN per 1,000 person-years was 5.9 for NGT, 7.8 for GGI, and 11.3 for GDM. The unadjusted (figure 1) and adjusted HTN risks were higher for GGI (HR 1.17 [95% CI 1.03-1.32]) and GDM (1.35 [1.13-1.63]) compared to NGT. Conclusion: GGI is associated with future HTN. Disclosure C.F. Escobar-Tomlienovich: None. D.C. Soria: None. D. Pant: None. T. Thaweethai: None. S. Hsu: None. K. James: None. J. Maya: None. C. Powe: Research Support; Current; Dexcom, Inc. Other - Associate Editor of Diabetes Care, Honoraria for Educational Materials; Current; American Diabetes Association. Other - Royalties for Up To Date chapters; Current; Wolters Kluwer (Up To Date). Other - Speaker; Ended; Medscape.
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Escobar-Tomlienovich et al. (2026) conducted a cohort in Gestational glucose intolerance (n=27,029). Gestational glucose intolerance (GGI) vs. Normal glucose tolerance (NGT) was evaluated on Incident hypertension (HR 1.17, 95% CI 1.03-1.32). Gestational glucose intolerance was associated with an increased risk of incident maternal hypertension compared to normal glucose tolerance (HR 1.17; 95% CI 1.03-1.32).
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