Gestational diabetes mellitus: A risk factor for hypertension in pregnancy
Journal Title: Indian Journal of Obstetrics and Gynecology Research - Year 2016, Vol 3, Issue 4
Abstract
Introduction: It has been reported that worldwide, one in 10 pregnancies is associated with diabetes, 90% of which are GDM. In India rates of GDM are estimated to be 10-15% with it expected to increase to 20%. There is a significant positive association between maternal hyperglycemia and adverse maternal outcome with the strongest association been found for hypertension in pregnancy. The present study is an effort to bring out the association between GDM and hypertension in pregnancy. Method: A prospective observational study was carried out on 1059 pregnant women. Amongst them, 129 who met the revised IADPSG criteria were diagnosed with GDM and rest included in normoglycemic group. Women with preeclampsia and gestational hypertension were included in the pregnancy associated hypertension (PAH) group. The risk of PAH in women with normoglycemia and GDM was calculated and maternal demographic factors associated with it identified. Result: There were 60 (3.8%) women with PAH. Normoglycemic women had lower rate of PAH, as compared to women with GDM (5.4% vs 7.8%, p>0.05). The risk of GDM patients developing pre-eclampsia was significantly more than normoglycemic women developing it (p<.05). Also, women with GDM and PAH had the highest rates of pregnancy after 35years, obesity, primiparity, and cesarean sections. Conclusion: This study demonstrates that GDM is associated with a higher incidence of PAH. There is a pre-pregnancy predisposition to dysfunction of beta cells which may be unmasked by the progressive insulin resistance of pregnancy and this is the common pathophysiology postulated with both GDM and hypertension in pregnancy. There is a necessity for early diagnosis and intensive monitoring of women with GDM for the development of PAH.
Authors and Affiliations
Meenakshi Kanwar Bharadwaj, Ganga Sagar Tiwary
Keywords
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