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A global view of hypertensive disorders and diabetes mellitus during pregnancy

Li Jiang1, Kun Tang1,2, Laura A Magee3

  • 1Centre for Global Child Health, The Hospital for Sick Children, Toronto, Canada.

Nature Reviews. Endocrinology
|September 15, 2022
PubMed

Insights

Maternal cardiometabolic disorders like hypertensive disorders in pregnancy (HDP) and gestational diabetes mellitus (GDM) disproportionately affect low-income regions. Addressing these conditions requires a multilevel approach beyond individual care to combat health inequities.

Area of Science:

  • Obstetrics and Gynecology
  • Cardiology
  • Endocrinology
  • Public Health

Background:

  • Maternal cardiometabolic disorders (CMDs), including hypertensive disorders in pregnancy (HDP) and gestational diabetes mellitus (GDM), represent a significant global health burden.
  • Lack of standardized diagnostic criteria for HDP and GDM complicates accurate assessment of disease burden across diverse regions.
  • These disorders disproportionately impact low- and middle-income countries (LMICs) and populations with lower sociodemographic and human development indexes.

Purpose of the Study:

  • To highlight the global disease burden of maternal cardiometabolic disorders (CMDs).
  • To emphasize the influence of social determinants of health and systemic marginalization on maternal CMDs.
  • To advocate for a multilevel approach and multisectoral partnerships to address health inequities related to maternal CMDs.

Main Methods:

  • Review of existing literature on the epidemiology and management of HDP and GDM.
  • Analysis of the impact of social determinants of health on maternal CMDs.
  • Discussion of current challenges in screening and management, including disruptions from the COVID-19 pandemic.

Main Results:

  • Maternal CMDs exhibit an uneven disease burden, particularly in LMICs.
  • Social determinants of health significantly influence the development and consequences of maternal CMDs.
  • The accuracy and long-term effects of screening and management programs require further investigation.

Conclusions:

  • A comprehensive, multilevel strategy involving multisectoral partnerships is essential to address the public health issues and health inequities stemming from maternal CMDs.
  • Women with maternal CMDs are particularly vulnerable during public health crises like the COVID-19 pandemic.
  • Further research is needed to refine screening and management protocols for HDP and GDM.

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