Oral Presentation International Association of the Diabetes and Pregnancy Study Groups 2022 - Hosted by ADIPS

Obesity as a driver of preeclampsia in women with Type 2 Diabetes (#36)

Margot Robinson 1 , Alison J Nankervis 1 2 , Tim Brown 3 , Sarah A Price 1 2 4
  1. Department of Obstetric Medicine, Royal Women's Hospital, North Melbourne, Victoria, Australia
  2. Diabetes and Endocrinology, Royal Melbourne Hospital, Parkville, Victoria, Australia
  3. School of Mathematics, Monash University, Clayton, Victoria, Australia
  4. Department of Medicine, University of Melbourne, Parkville, Victoria, Australia

Background: Preeclampsia is a devastating complication of pregnancy that claims the lives of thousands of mothers and babies each year. Studies have suggested that maternal obesity is a driver of preeclampsia. Inflammatory factors and leptin/soluble leptin receptor are hypothesised as possible mediators linking these conditions. Although meta-analyses and multi-centre cohorts have supported the association between obesity and preeclampsia, there are no studies that have specifically explored this association in women with Type 2 Diabetes (T2D). 

Methods: Using a single-centre retrospective database of pregnancy outcomes in women with T2D, we identified subjects with booking weight and height data and with known pregnancy outcomes. Exploratory analysis of relevant variables was conducted. Temporal trends in maternal weight and the incidence of pre-eclampsia were explored. A generalised linear model was used to examine the relationship between the log of the probability of pre-eclampsia with time of first visit and early pregnancy body weight. All analysis was performed using the statistical package R.

Results: Of the 648 subjects with T2D identified, 349 women had adequate anthropometric and pregnancy outcome data for inclusion in the analysis. Over the 20-year period, the incidence of preeclampsia increased (p and r). Preeclampsia occurred in 45/349 (13%) of the subjects. There was a statistically significant relationship  between booking weight (<20 weeks gestation) and the development of preeclampsia (p=0.01), after controlling for the also statistically significant relationship with time (p=0.04).

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Summary: In a population of women with pre-existing T2D, there was a significant correlation between body weight in early pregnancy and occurrence of preeclampsia. This study reinforces the need for mechanistic studies to understand the relationship between maternal obesity and preeclampsia.