Pre-eclampsia is associated with a twofold increase in diabetes: a systematic review and meta-analysis

Pensee Wu, Chun Shing Kwok, Randula Haththotuwa, Rafail A Kotronias, Aswin Babu, Anthony A. Fryer, Phyo K. Myint, Carolyn A Chew-Graham, Mamas A Mamas

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Pre-eclampsia is a pregnancy-specific multisystem disorder and a state of physiological insulin resistance. Our aim was to systematically evaluate and quantify the evidence on the relationship between pre-eclampsia and the future risk of diabetes.


We conducted a systematic review and meta-analysis of studies that evaluated diabetes in women with and without pre-eclampsia. We performed a systematic search of MEDLINE and EMBASE to identify relevant studies. Independent double data extractions were conducted by four reviewers. Random-effects meta-analysis was used to estimate the risk of future diabetes following pre-eclampsia.


A total of 21 studies were identified with more than 2.8 million women, including more than 72,500 women with pre-eclampsia. Meta-analysis of studies that adjusted for potential confounders demonstrated that pre-eclampsia was independently associated with an increased risk of future diabetes (RR 2.37 [95% CI 1.89, 2.97]). This risk appeared in studies that followed women from less than 1 year postpartum (RR 1.97 [95% CI 1.35, 2.87]) and persisted to more than 10 years postpartum (RR 1.95 [95% CI 1.28, 2.97]). After adjusting for BMI or gestational diabetes, pre-eclampsia remained linked with an increased risk of future diabetes (RR 2.38 [95% CI 1.74, 3.24] and RR 2.36 [95% CI 1.94, 2.88], respectively).


Pre-eclampsia is independently associated with a twofold increase in future diabetes. Our study highlights the importance of clinical risk assessment for the future development of diabetes in women with pre-eclampsia. We recommend detailed evaluation of a screening programme for diabetes in this high-risk population.
Original languageEnglish
Pages (from-to)2518-2526
Number of pages9
Issue number12
Early online date19 Sept 2016
Publication statusPublished - Dec 2016

Bibliographical note

CSK and RH are funded by National Institute for Health Research Academic Clinical Fellowships. This study was supported by a grant from the North Staffs Heart Committee.


  • diabetes mellitus
  • meta-analysis
  • pre-eclampsia
  • risk predictors
  • screening
  • systematic review


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