High blood pressure and high blood sugar levels are becoming more and more common in pregnancy due to the increasing age of mothers and the increases in obesity rates among mothers.
High blood pressure increases the risk of pregnancy problems such as baby dying in the womb, and small babies. On the other hand, high blood sugar levels increases the risk of high blood pressure during pregnancy and big babies.
Both high blood pressure and high blood sugar levels in the mother during pregnancy increases the risk of women and their babies to the development of overweight, high blood pressure and high blood sugar levels later in life.
It still not fully understood that how the combination of high blood pressure and high blood sugar levels affect both mothers and her babies during pregnancy as well as after birth.
This study aims to find out how high blood pressure and/or high blood sugar levels during pregnancy could affect pregnancy results and long-term health of the mother. Our findings may provide new knowledge for improving the pregnancy care, finding out women at risk and providing timely treatment to decrease pregnancy problems.
This study aims to estimate the incidence of women who were diagnosed with both hyperglycaemic and hypertensive disorders during their pregnancy; and recognise potential risk factors for the co-occurrence of these two disorders. Additionally, we will also investigate the potential impacts of these two disorders together on reproductive and birth outcomes for both mothers and offspring.
The cohort will include patients with both antenatal check-ups and maternity records between 01/01/2000 to latest release. The trends in the incidence of co-occurrence of both hyperglycaemia and hypertensive disorders among pregnancies will be evaluated firstly. This incidence number will also be compared to the theoretical probability of co-occurrence (if these two disorders are independent) to assess the association between with hyperglycaemia and hypertension during pregnancy.
Determinants of potential risk factors such as age, body mass index (BMI), ethnicity, other pregnancy complications, ethnicity, smoking status, deprivation index, mental health and geographic area, PCOS, COVID-19 infection, etc. will be extracted based on the information available within CPRD-HES data. And we will use multivariate logistic regression models to estimate the association of these factors to co-occurrence of both disorders.
All missing data will be addressed through complete-case analysis, with a sensitivity analysis carried out using multiple imputation to address missing data.
This study will provide novel and inclusive information about the possible predisposition to these two common pregnancy disorders (hyperglycaemic and hypertensive disorders during pregnancy), and their impacts on maternal and offspring health, which will aid clinicians and healthcare professionals in improving the quality of provided health services.
• Annual incidence of hyperglycaemia and hypertension complicated pregnancy since 2000;
• Association of co-occurrence of hyperglycaemia and hypertension complicated pregnancy with possible determinants such as age, body mass index (BMI), ethnicity, smoking status, alcohol intake, geographic area, PCOS, and COVID-19 infection;
• Reproductive and birth outcomes include: birth weight (both LGA and SGA); rate of C-section, preterm birth, stillbirth, birth trauma, as well as postpartum depression;
• Long-term metabolic outcomes in the mothers include: postpartum obesity, diabetes, hypertension, cardiomyopathy, chronic kidney disease and non-alcoholic fatty liver disease.
Bee Tan - Chief Investigator - University of Leicester
Bee Tan - Corresponding Applicant - University of Leicester
Clare Gillies - Collaborator - University of Leicester
Elpida Vounzoulaki - Collaborator - University of Leicester
Evgeny Mirkes - Collaborator - University of Leicester
Jiamiao Hu - Collaborator - University of Leicester
Kamlesh Khunti - Collaborator - University of Leicester
Sharmin Shabnam - Collaborator - University of Leicester
HES Admitted Patient Care;Patient Level Index of Multiple Deprivation