The association of circulating angiogenic factors and HbA1c with the risk of preeclampsia in women with preexisting diabetes

Figures & data

Table 1. Characteristics of diabetic subjects with and without hypertensive complications and non-diabetic controls.

	Non-diabetic controls (n = 139)	Diabetes non-PE (n = 103)	Diabetes PE (n = 19)	p Value*	Diabetes GHTN (n = 37)	p Value*
Mother’s age (years)	33.7 ± 4.7	32.6 ± 5.2	31.3 ± 5.7	0.33	32.4 ± 5.9	0.86
BMI (Prior to or at first PNV)	24.5 ± 4.2	28.2 ± 6.0	31.8 ± 10.1	0.15	27.1 ± 3.8	0.23
Race (%)				0.32		0.29
Caucasian	80.6 (112)	86.4 (89)	73.7 (14)		97.3 (36)
Black	5.0 (7)	4.9 (5)	15.8 (3)		0.0 (0)
Asian	10.8 (15)	2.9 (3)	5.3 (1)		0.0 (0)
Hispanic	1.4 (2)	5.8 (6)	5.3 (1)		2.7 (1)
Smoker (%)	1.4 (2)	7.8 (8)	15.8 (3)	0.26	2.7 (1)	0.28
History of hypertension (%)	1.4 (2)	15.5 (16)	36.8 (7)	0.02†	2.7 (1)	0.04†
Retinopathy – first (%)		26.2 (27)	42.1 (8)	0.007†	40.5 (15)	0.09
Retinopathy – third (%)		30.1 (31)	47.4 (9)	0.002†	46.0 (17)	0.04†
Nephropathy (%)		12.6 (13)	21.1 (4)	0.15	0.0 (0)	0.02†
History of preeclampsia (%)	5.8 (8)	10.7 (11)	26.3 (5)	0.02†	5.4 (2)	0.34
Parity	1 ± 1	1 ± 1	1 ± 1	0.57	1 ± 1	0.64
Years with DM		12.9 ± 8.9	15.4 ± 9.3	0.29	15.0 ± 7.7	0.19
HbA1C (baseline)		6.7 ± 1.1	7.7 ± 1.1	0.001†	7.0 ± 1.6	0.32
HbA1C (delivery)		6.1 ± 0.6	6.2 ± 0.4	0.41	6.4 ± 0.8	0.03†
Type 1 DM (%)		72.8 (75)	68.4 (13)	0.65	78.4 (29)	0.56
Gestational age in weeks at delivery	38.9 ± 1.5	37.2 ± 2.2	35.9 ± 2.0	0.01†	37.5 ± 1.3	0.44
C-section (%)	38.9 (54)	76.7 (79)	94.7 (18)	0.08	86.5 (32)	0.24
Baby weight (g)	3346 ± 455	3601 ± 779	2958 ± 669	0.001†	3652 ± 576	0.68
BW for GA (percentile)	48.9 ± 24.9	72.4 ± 26.1	54.0 ± 28.7	0.007†	76.4 ± 23.9	0.43
Baby gender (males) (%)	49.6 (69)	41.8 (43)	31.6 (6)	0.48	51.4 (19)	0.27
SBP at first prenatal visit	113 ± 10	115 ± 11	125 ± 13	0.001†	119 ± 8	0.02†
DBP at first prenatal visit	70 ± 8	71 ± 8	72 ± 8	0.43	74 ± 6	0.005†

*Significance compared to diabetic non-PE.

†Significant at <0.05 level.

Table shows mean ± standard deviation or percent (sample size) where appropriate.

PE = preeclampsia, GHTN = gestational hypertension, BMI = body mass index, PNV = prenatal visit, DM = diabetes mellitus, BW = birth weight, GA = gestational age, SBP = systolic blood pressure, DBP = diastolic blood pressure.

Table 2. Multiple of the median (MOM)* for various angiogenic markers in diabetic pregnancies.

Markers	Gestational age (years)	Non-diabetic controls† (median) N = 139	Diabetes non-PE (MOM) N = 103	p Value‡	Diabetes PE (MOM) N = 19	p Value‡	p Value§	Diabetes GHTN (MOM) N = 37	p Value‡	p Value§
sFlt-1/PIGF	11–18	39.3	1.34 (0.66, 2.26)	0.04¶	1.49 (0.99, 3.05)	0.08	0.40	1.45 (0.57, 2.24)	0.10	0.82
	19–26	5.0	1.66 (0.83, 3.34)	0.05	1.10 (0.58, 2.00)	0.77	0.33	2.20 (0.75, 4.40)	0.08	0.58
	27–34	2.8	1.45 (0.78, 11.95)	0.12	15.18 (2.37, 26.86)	0.001¶	0.03¶	5.56 (0.94, 25.29)	0.01¶	0.14
	35–40	39.6	3.21 (1.19, 7.24)	0.0001¶	8.61 (1.20, 18.27)	0.01¶	0.32	6.17 (2.28, 10.87)	<0.0001¶	0.16
sFlt-1	11–18	2218	1.16 (0.58, 1.81)	0.32	0.94 (0.37, 1.17)	0.49	0.13	0.87 (0.57, 1.78)	0.96	0.45
	19–26	2080	1.28 (0.68, 2.18)	0.25	0.83 (0.31, 1.42)	0.22	0.05	1.27 (0.56, 2.17)	0.40	0.90
	27–34	1746	1.86 (0.89, 4.48)	0.03¶	2.78 (1.09, 5.93)	0.05	0.50	2.01 (0.80, 4.51)	0.11	0.98
	35–40	8266	2.21 (0.87, 3.76)	0.001¶	2.74 (0.75, 6.56)	0.12	0.86	2.89 (1.09, 4.69)	0.002¶	0.29
PIGF	11–18	78.7	0.80 (0.46, 1.30)	0.39	0.52 (0.38, 0.95)	0.09	0.17	0.60 (0.32, 1.26)	0.11	0.21
	19–26	412.3	0.84 (0.52, 1.31)	0.18	0.62 (0.33, 1.34)	0.15	0.32	0.68 (0.46, 1.19)	0.09	0.46
	27–34	581.6	1.01 (0.43, 1.68)	0.75	0.24 (0.20, 0.37)	<0.0001¶	0.001¶	0.75 (0.31, 1.41)	0.15	0.23
	35–40	181.3	0.66 (0.48, 1.39)	0.004¶	0.50 (0.32, 0.69)	0.001¶	0.04¶	0.59 (0.41, 0.83)	<0.0001¶	0.10

PE = preeclampsia, GHTN = gestational hypertension.

Tables shows median (Q1, Q3).

*Multiple of median of circulating concentrations in non-diabetic controls.

†Median concentrations of sFlt1 and PlGF in pg/ml and sFlt/PlGF ratio.

‡Compared to non-diabetic controls.

§Compared to cases (diabetics) without PE and without GHTN.

¶Significant at p < 0.05.

Table 3. Relative risk of preeclampsia with HBA1C cut-offs among diabetics.

			Univariate		Multivariable†
HBA1C	% (n) <HBA1C	% (n) ≥HBA1C	RR (95% CI)	p Value	RR (95% CI)	p Value
≥6.5	48.1 (76)	51.9 (82)	4.63 (1.40–15.38)	0.01*	4.42 (1.35–14.47)	0.01*
≥7	67.1 (106)	32.9 (52)	5.30 (2.00–14.07)	0.001*	5.26 (2.06–13.41)	0.001*
≥7.5	78.5 (124)	21.5 (34)	5.73 (2.41–13.66)	<0.0001*	5.60 (2.50–12.56)	<0.0001*
≥8	85.4 (135)	14.6 (23)	4.70 (2.08–10.64)	0.0002*	4.60 (2.18–9.69)	<0.0001*

*Significant at <0.05 level.

†Controlling for parity and body mass index.