Sex and Gender Determinants of Increased Blood Pressure Among Women With Previous Gestational Diabetes Mellitus in Rural China

Abstract

Background: Gestational diabetes mellitus (GDM) increases the long-term risk of hypertension and cardiovascular events for mothers later in life but has not been well recognized by nurses. The aims of the study were to describe the proportion of increased blood pressure in rural women with previous GDM and to explore the sex (biological) and gender (sociocultural) factors that contribute to the increased blood pressure.Methods: A cross-sectional descriptive survey including 397 women with previous GDM was conducted in rural areas of Central South of China between November 2017 and June 2018. The variables of sex (e.g., age, ethnicity, family history of hypertension, time since delivery, 75-g oral glucose tolerance test, body mass index, and waist circumference) and gender (education, occupation, income, physical activity, fruit and vegetable intake, sedentary time, perceived stress, and general self-efficacy) were collected on research site. Increased blood pressure referred to systolic blood pressure of ≥130 mm Hg and/or diastolic blood pressure of ≥85 mm Hg. Logistic regression was performed to recognize the sex and gender factors associated with increased blood pressure. Results: There were nearly 20% (78/397) of participants first found increased blood pressure. Among those participants who had increased blood pressure, advanced age, a family history of hypertension, and abnormal 2-h plasma glucose levels were sex-related factors associating with the increased blood pressure (P < 0.05), while obesity indicators (body mass index and waist circumference) were not associated (P > 0.05). General self-efficacy, a gender factor, had a protective relationship with increased blood pressure (P < 0.05). Conclusions: Increased blood pressure is prevalent in rural Chinese women with previous GDM. Both sex and gender are determinants. Interventions promoting glycemic status and general self-efficacy are promising to improve their cardiovascular health later in life.