Hypertensive disorders of pregnancy, gestational diabetes, and the risk of adverse pregnancy outcomes in Greenland: a nationwide study
PhD student: Bodil Hoffmeyer
Institutions: Steno Diabetes Center Greenland; Ilisimatusarfik – University of Greenland, Institute of Health & Nature; Copenhagen University, Department of Clinical Medicine
Granted amount: DKK 1.349.665
Background: Maternal and infant health in Greenland and the Arctic face significant challenges, including increased rates of stillbirth, preterm birth, and infant mortality. Two important pregnancy complications are hypertensive disorders of pregnancy, including pre-eclampsia, and gestational diabetes mellitus (GDM). These conditions pose serious risks to pregnant women and their offspring but remain under-researched in Greenland.
Pre-eclampsia is a hypertensive disorder of pregnancy, characterized by high blood pressure and maternal organ dysfunction during pregnancy, which can lead to severe complications such as fetal growth restriction, preterm birth, stillbirth, and increased long-term risk of cardiovascular diseases for mothers. Despite these serious risks, research in hypertensive disorders of pregnancy
among Inuit women is limited, but the prevalence is believed to be rising in Greenland due to increasing rates of hypertension and diabetes in the general population.
Gestational Diabetes Mellitus (GDM) is characterized by increased blood sugar levels during pregnancy, increasing the risk of complications like larger-than-average babies, caesarean delivery, preterm birth, low blood sugar in newborns, and pre-eclampsia. It also raises the long-term risk of diabetes and cardiovascular diseases for both mother and child. Proper management, often through diet and exercise, can effectively reduce these risks. Research on GDM in Greenland is scarce, but several factors indicate that many Greenlandic women may be at higher risk of GDM. However, existing evidence suggests significant GDM underdiagnosis in Greenland due to inadequate screening. Therefore, starting in January 2024, all pregnant women in Greenland are recommended screening for GDM using an oral glucose tolerance test.
Study Objectives: With this project, we aim to determine the prevalence of hypertensive disorders
of pregnancy, including pre-eclampsia, from 2019 to 2023, and GDM from 2019 to 2025 (before and after implementation of the new GDM screening). Also, we will identify risk factors and evaluate the risk of adverse pregnancy outcomes associated with these conditions. Additionally, the effectiveness of the new GDM screening method will be assessed.
Methods: The project consists of three register-based cohort studies using data extracted anonymously from Greenland’s electronic medical records, ensuring no direct involvement or risk to individuals. Ethical guidelines will be strictly followed to protect patient privacy and data security.
Conclusion: This project addresses crucial knowledge gaps in the health of Greenlandic pregnant
women and their babies. The findings will help improve screening, prevention, and management strategies for hypertensive disorders of pregnancy and GDM, ultimately enhancing maternal and newborn health in Greenland. Furthermore, this work aims to lay the foundation for future research on maternal and child health in the Arctic.
