ResearchObstetricsHyperglycemia and Adverse Pregnancy Outcome (HAPO) study: preeclampsia
Section snippets
Materials and Methods
The HAPO study was an international, multicenter epidemiologic study. Detailed methods have been reported.19, 20 The study was approved by the local institutional review board at each center. All participants gave written informed consent, and the study was overseen by an external Data Monitoring Committee.
Results
There were 1116 cases of preeclampsia among the 23,316 blinded participants. In addition, 582 women had chronic hypertension, and 1370 women experienced gestational hypertension. Only the women who remained normotensive (20,248) or who experienced preeclampsia are included in these analyses. Characteristics of these 21,364 women are shown in Table 1. Maternal age, BMI, and glucose values at the OGTT and gestational age at delivery are similar to those that have been reported for the entire
Comment
We previously reported continuous positive associations between maternal glucose values and preeclampsia.20 In this report, we examined the associations of insulin levels (measured as fasting C-peptide) and maternal BMI with preeclampsia. Fasting indices of C-peptide provide an acceptable measure of insulin sensitivity in pregnancy.23 We also more fully examined the relationship of maternal glucose values with preeclampsia, which included the effect of adjustment for fasting C-peptide. Our main
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2021, American Journal of Obstetrics and GynecologyCitation Excerpt :Preterm delivery was not examined because, as described previously, it was an exclusion criterion for HAPO FUS (and therefore this ancillary study). Maternal blood pressures (in addition to those measured at the baseline HAPO exam), urine protein, and delivery mode and indication were abstracted from the medical records, and preeclampsia was defined using the International Society for the Study of Hypertension in Pregnancy guidelines.32,33 Newborn weight, length, and skinfold thicknesses (flank, subscapular, triceps) were measured by trained study personnel.8,34
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Supported by from the National Institute of Child Health and Human Development and the National Institute of Diabetes, Digestive, and Kidney Diseases (Grants R01-HD34242 and R01-HD34243); the National Center for Research Resources (M01-RR00048, M01-RR00080); the American Diabetes Association; Diabetes UK (RD04/0002756); Kaiser Permanente Medical Center; KK Women's and Children's Hospital; Mater Mother's Hospital; Novo Nordisk; the Myre Sim Fund of the Royal College of Physicians of Edinburgh, and the Howard and Carol Bernick Family Foundation.
The Writing Group takes responsibility for the content of this article. Members of the HAPO Study Cooperative Research Group are listed in the appendix of: HAPO Study Cooperative Research Group. Hyperglycemia and Adverse Pregnancy Outcomes. N Engl J Med 2008;358:1991-2002.
Cite this article as: The Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study Cooperative Research Group. Hyperglycemia and Adverse Pregnancy Outcome (HAPO) Study: preeclampsia. Am J Obstet Gynecol 2010;202:255.e1-7.
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Reprints: Boyd E. Metzger, MD, Northwestern University Feinberg School of Medicine, Endocrinology, 645 N Michigan Ave., Suite 530-22, Chicago, IL 60611.
From the members of the Writing Group [Division of Maternal-Fetal Medicine, Rabin Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Petah-Tiqva, Israel (Drs Yogev, Chen, and Hod); the Department of Obstetrics and Gynecology, Women and Infants Hospital of Rhode Island, Alpert Medical School of Brown University, Providence, RI (Dr Coustan); the Diabetes Service, Royal Women's Hospital, Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, VIC, Australia (Dr Oats); the Department of Endocrinology and Obstetric Medicine, Mater Health Services and Mater Clinical School of Medicine, University of Queensland, Brisbane, QLD, Australia (Dr McIntyre); the Division of Endocrinology, Department of Medicine (Dr Metzger), the Department of Preventive Medicine (Drs Lowe and Dyer), and the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology (Dr Dooley), Northwestern University Feinberg School of Medicine, Chicago, IL; the Diabetes Research Group, Queen's University Belfast (Dr Trimble), the Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital (Dr McCance), and the Regional Centre for Endocrinology and Diabetes, Royal Victoria Hospital, and Royal Jubilee Maternity Hospital and Queen's University Belfast (Dr Hadden), Belfast, UK; the Department of Women and Child Health, Karolinska Institute, Stockholm, Sweden (Dr Persson); and the Department of Obstetrics and Gynaecology, Chinese University of Hong Kong, Hong Kong, People's Republic of China (Dr Rogers)].