Maternal overweight and obesity and risk of pre-eclampsia in women with type 1 diabetes or type 2 diabetes

• Aims/hypothesis Women with type 1 or type 2 diabetes are at increased risk of pre-eclampsia. Overweight and obesity are associated with an increased risk of pre-eclampsia in women without diabetes. The aim of the study was to investigate the impact of maternal overweight and obesity on the risk of pre-eclampsia in women with type 1 diabetes or type 2 diabetes. MethodsIn a population-based cohort study including singleton births in Sweden, we estimated the risk of pre-eclampsia among women with type 1 diabetes (n = 7062) and type 2 diabetes (n = 886), and investigated whether maternal overweight (BMI 25-29.9 kg/m(2)) and obesity (BMI aeyen30.0 kg/m(2)) modified the risk. Logistic regression analyses were used to estimate crude and adjusted ORs with 95% CIs, using women without diabetes as the reference group (n = 1,509,525). Results Compared with women without diabetes, the adjusted ORs for pre-eclampsia in women with type 1 and type 2 diabetes were 5.74 (95% CI 5.31, 6.20) and 2.11 (95% CI 1.65, 2.70), respectively. The corresponding risks of pre-eclampsia combined with preterm birth were even higher. Risks of pre-eclampsia increased with maternal overweight (BMI 25-29.9 kg/m(2)) and obesity (BMI aeyen30.0 kg/m(2)), foremost in women without diabetes, to a lesser extent in women with type 1 diabetes but not in women with type 2 diabetes. Conclusions/interpretation Maternal overweight and obesity increased risks of pre-eclampsia in women with type 1 diabetes but not in women with type 2 diabetes. Even so, considering associations between maternal BMI and overall maternal and offspring risk, all women (with and without diabetes) should aim for a normal weight before pregnancy.

Subject headings

Medical and Health Sciences  (hsv)

Clinical Medicine  (hsv)

Endocrinology and Diabetes  (hsv)

Medicin och hälsovetenskap  (hsv)

Klinisk medicin  (hsv)

Endokrinologi och diabetes  (hsv)

Obstetrics, Gynecology and Reproductive Medicine  (hsv)

Reproduktionsmedicin och gynekologi  (hsv)

Keyword

BMI

Diabetestype 1

Diabetes type 2

Moderate pre-eclampsia

Obesity

Overweight

Pre-eclampsia

Risk of pre-eclampsia

Severe pre-eclampsia