Evidence from a large Chinese birth cohort indicates that persistently elevated SBP is a significant determinant of GDM. The study, published in Diabetes, Metabolic Syndrome and Obesity, combined longitudinal blood pressure measurements with genetic analyses to clarify both association and causality.

Among 5,952 pregnant individuals, higher first-trimester SBP and increased mean SBP throughout pregnancy were linked with greater GDM risk. Participants with a High-stable SBP trajectory had significantly higher odds of GDM than those with a Low-stable trajectory. Genetic data reinforced these findings. The highest quintile of genetically predicted SBP carried 54% greater GDM odds, and European datasets demonstrated a modest genetic correlation between SBP and GDM. Mendelian randomization analyses further suggested a causal effect, with higher genetically predicted SBP increasing GDM risk by 42%.

Together, these results highlight SBP as an early and actionable marker of GDM risk. Persistent SBP elevation during pregnancy may warrant closer surveillance and risk-adapted preventive strategies.