Key result
Co-occurring gestational diabetes and hypertensive disorders linked to ~164% higher incident heart failure risk.
Why the study?
The extent to which the co-occurrence of gestational hypertensive disorders and gestational diabetes mellitus influences heart failure risk was unclear.
Does the co-occurrence of gestational diabetes mellitus and gestational hypertensive disorders increase the risk of incident heart failure in women with a livebirth singleton delivery?
Cohort (n=885,873)
Does the co-occurrence of gestational diabetes mellitus and gestational hypertensive disorders increase the risk of incident heart failure in women with a livebirth singleton delivery?
Hazard Ratio: 2.64 (95% CI 1.24–5.61)
The co-occurrence of gestational diabetes and gestational hypertensive disorders significantly increases the long-term risk of incident heart failure in women.
May support closer postpartum HF monitoring in affected women; hypothesis-generating and requires prospective validation.
BACKGROUND: The extent to which their co-occurrence of gestational hypertensive disorders (GHTD) and gestational diabetes mellitus (GDM) influences heart failure (HF) risk is unclear. OBJECTIVES: The purpose of this study was to characterize the risk of HF related to concomitant GHTD and GDM. METHODS: We conducted a population-based cohort study using the Ministry of Health and Long-Term Care of Ontario (Canada) health care administrative databases. We included women with a livebirth singleton delivery between July 1, 2007, and March 31, 2018, and excluded those with prepregnancy diabetes, hypertension, HF, or coronary artery disease. GDM, GHTD, peripartum cardiomyopathy (at index pregnancy) were identified using diagnosis coding. Incident HF was assessed from index pregnancy until March 31, 2020. We estimated associations of GDM and/or GHTD with peripartum cardiomyopathy and incident HF. RESULTS: Among 885,873 women (mean age: 30 years, 54,015 with isolated GDM, 43,750 with isolated GHTD, 4,960 with GDM and GHTD), there were 489 HF events over 8 years. Compared to no-GDM and no-GHTD, isolated GDM (adjusted hazard ratio [aHR]: 1.44; 95% CI: 1.02-2.04) and isolated GHTD (aHR: 1.65; 95% CI: 1.17-2.31) were associated with a higher risk of incident HF. The co-occurrence of GDM and GHTD was associated with a higher HF risk (aHR: 2.64; 95% CI: 1.24-5.61). GDM and GHTD increased the risk of peripartum cardiomyopathy (adjusted risk ratio [aRR]: 7.30; 95% CI: 6.92-7.58), similarly to isolated GHTD (aRR: 7.40; 95% CI: 7.23-7.58). CONCLUSIONS: The co-occurrence of GDM and GHTD was associated with a significantly high risk of incident HF.
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Echouffo‐Tcheugui et al. (2023) conducted a cohort in Gestational hypertensive disorders and gestational diabetes mellitus (n=885,873). Co-occurrence of gestational diabetes mellitus and gestational hypertensive disorders vs. No gestational diabetes and no gestational hypertensive disorders was evaluated on Incident heart failure (HR 2.64, 95% CI 1.24-5.61). The co-occurrence of gestational diabetes and gestational hypertensive disorders was associated with a higher risk of incident heart failure (aHR 2.64; 95% CI 1.24-5.61).
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