Maternal obesity and risk of pre-eclampsia in women with type 1 or type 2 diabetes

This study investigated the connections between maternal weight and pre-eclampsia in women with type 1 or type 2 diabetes. The study determined that maternal overweight and obesity increased the risk of pre-eclampsia in women with type 1 diabetes, but not in women with type 2 diabetes. 

Pre-eclampsia is a very serious condition that can happen in the third trimester of pregnancy. Pre-eclampsia is associated with high blood pressure in the mother, and increased risks of stillbirth, preterm birth, and infant death. Increased maternal weight increases the risk of pre-eclampsia in women without diabetes.

Diabetes has been associated with a 2 to 6 times higher risk of pre-eclampsia compared to women without diabetes. Whether overweight or obese women with type 1 or type 2 diabetes are at an even higher risk of pre-eclampsia is unclear.

The study included 7,062 women with type 1 diabetes and 886 women with type 2 diabetes. All of the women had given birth.

Compared with women without diabetes, women with type 1 diabetes had 5.74 times the odds of developing pre-eclampsia. The odds were 2.11 times higher in women with type 2 diabetes. The risk of pre-eclampsia increased with maternal weight, mainly in women without diabetes but to some extent in women with type 1 diabetes.  In women with type 2 diabetes, overweight and obesity were not associated with increased risks of pre-eclampsia compared with normal weight.

The study concluded that maternal overweight and obesity increased the risk of pre-eclampsia in women with type 1 diabetes. There was no increase in risk in overweight or obese women with type 2 diabetes. The authors recommended that all women (with or without diabetes) should aim for a normal weight before pregnancy. 

There was limited information on duration of diabetes or diabetes-related complications.