TY - JOUR

T1 - Prediction and prevention of preeclampsia in women with preexisting diabetes

T2 - the role of home blood pressure, physical activity, and aspirin

AU - Do, Nicoline Callesen

AU - Vestgaard, Marianne

AU - Nørgaard, Sidse Kjærhus

AU - Damm, Peter

AU - Mathiesen, Elisabeth R.

AU - Ringholm, Lene

N1 - Publisher Copyright: Copyright © 2023 Do, Vestgaard, Nørgaard, Damm, Mathiesen and Ringholm.

PY - 2023

Y1 - 2023

N2 - Women with type 1 or type 2 (preexisting) diabetes are four times more likely to develop preeclampsia compared with women without diabetes. Preeclampsia affects 9%–20% of pregnant women with type 1 diabetes and 7%–14% of pregnant women with type 2 diabetes. The aim of this narrative review is to investigate the role of blood pressure (BP) monitoring, physical activity, and prophylactic aspirin to reduce the prevalence of preeclampsia and to improve pregnancy outcome in women with preexisting diabetes. Home BP and office BP in early pregnancy are positively associated with development of preeclampsia, and home BP and office BP are comparable for the prediction of preeclampsia in women with preexisting diabetes. However, home BP is lower than office BP, and the difference is greater with increasing office BP. Daily physical activity is recommended during pregnancy, and limiting sedentary behavior may be beneficial to prevent preeclampsia. White coat hypertension in early pregnancy is not a clinically benign condition but is associated with an elevated risk of developing preeclampsia. This renders the current strategy of leaving white coat hypertension untreated debatable. A beneficial preventive effect of initiating low-dose aspirin (150 mg/day) for all in early pregnancy has not been demonstrated in women with preexisting diabetes.

AB - Women with type 1 or type 2 (preexisting) diabetes are four times more likely to develop preeclampsia compared with women without diabetes. Preeclampsia affects 9%–20% of pregnant women with type 1 diabetes and 7%–14% of pregnant women with type 2 diabetes. The aim of this narrative review is to investigate the role of blood pressure (BP) monitoring, physical activity, and prophylactic aspirin to reduce the prevalence of preeclampsia and to improve pregnancy outcome in women with preexisting diabetes. Home BP and office BP in early pregnancy are positively associated with development of preeclampsia, and home BP and office BP are comparable for the prediction of preeclampsia in women with preexisting diabetes. However, home BP is lower than office BP, and the difference is greater with increasing office BP. Daily physical activity is recommended during pregnancy, and limiting sedentary behavior may be beneficial to prevent preeclampsia. White coat hypertension in early pregnancy is not a clinically benign condition but is associated with an elevated risk of developing preeclampsia. This renders the current strategy of leaving white coat hypertension untreated debatable. A beneficial preventive effect of initiating low-dose aspirin (150 mg/day) for all in early pregnancy has not been demonstrated in women with preexisting diabetes.

KW - aspirin

KW - home blood pressure

KW - hypertension

KW - physical activity

KW - preeclampsia

KW - preexisting diabetes

KW - pregnancy

KW - sedentary behavior

U2 - 10.3389/fendo.2023.1166884

DO - 10.3389/fendo.2023.1166884

M3 - Review

C2 - 37614711

AN - SCOPUS:85168490486

VL - 14

JO - Frontiers in Endocrinology

JF - Frontiers in Endocrinology

SN - 1664-2392

M1 - 1166884

ER -