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A global view of hypertensive disorders and diabetes mellitus during pregnancy

Research output: Contribution to journalReview articlepeer-review

Li Jiang, Kun Tang, Laura A. Magee, Peter von Dadelszen, Alec Ekeroma, Xuan Li, Enyao Zhang, Zulfiqar A. Bhutta

Original languageEnglish
Pages (from-to)760-775
Number of pages16
JournalNature Reviews Endocrinology
Volume18
Issue number12
Early online date15 Sep 2022
DOIs
Accepted/In press28 Jul 2022
E-pub ahead of print15 Sep 2022
PublishedDec 2022

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Publisher Copyright: © 2022, Springer Nature Limited.

King's Authors

Abstract

Two important maternal cardiometabolic disorders (CMDs), hypertensive disorders in pregnancy (HDP) (including pre-eclampsia) and gestational diabetes mellitus (GDM), result in a large disease burden for pregnant individuals worldwide. A global consensus has not been reached about the diagnostic criteria for HDP and GDM, making it challenging to assess differences in their disease burden between countries and areas. However, both diseases show an unevenly distributed disease burden for regions with a low income or middle income, or low-income and middle-income countries (LMICs), or regions with lower sociodemographic and human development indexes. In addition to many common clinical, demographic and behavioural risk factors, the development and clinical consequences of maternal CMDs are substantially influenced by the social determinants of health, such as systemic marginalization. Although progress has been occurring in the early screening and management of HDP and GDM, the accuracy and long-term effects of such screening and management programmes are still under investigation. In addition to pharmacological therapies and lifestyle modifications at the individual level, a multilevel approach in conjunction with multisector partnership should be adopted to tackle the public health issues and health inequity resulting from maternal CMDs. The current COVID-19 pandemic has disrupted health service delivery, with women with maternal CMDs being particularly vulnerable to this public health crisis.

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