Population-based study on birth outcomes among women with hypertensive disorders of pregnancy and gestational diabetes mellitus

Abstract

To evaluate birth outcomes in women with hypertensive disorders of pregnancy (HDP) and gestational diabetes mellitus (GDM), we used insurance data of Taiwan to evaluate 11 adverse neonatal outcomes of infants born to women with HDP (N = 7775) and with both HDP and GDM (HDP/GDM) (N = 1946), comparing to women with neither disorder (N = 19,442), matched by age. The impacts of preeclampsia/eclampsia were also evaluated. Results showed that Caesarean section delivery was near 1.7-fold greater in the HDP/GDM and HDP groups than in comparisons. The preterm delivery rates were more than threefold greater in HDP/GDM group and HDP group than in comparisons with adjusted odds ratios (aORs) of 4.84 (95% confidence interval (CI) 4.34–5.40) and 3.92 (95% CI 3.65–4.21), respectively, followed by jaundice (aORs 2.95 (95% CI 2.63–3.33) and 1.90 (95% CI 1.76–2.06)), and small gestation age (SGA) (aORs 6.57 (95% CI 5.56–7.75) and 5.81 (95% CI 5.15–6.55)). Incidence rates of birth trauma, patent ductus arteriosus, atrial septal defect, respiratory distress syndrome, and neonatal hypoglycemia were also higher in the HDP/GDM and HDP groups than in the comparison group. Most adverse outcomes increased further in women with preeclampsia or eclampsia. In conclusion, women with HDP are at elevated risks of adverse neonatal outcomes. Risks of most adverse outcomes increase further for women with both HDP and GDM. Preeclampsia or eclampsia may also contribute to these outcomes to higher risk levels. Every pregnant woman with these conditions deserves specialized prenatal care.

Prevalence and Immediate Outcomes of Low Birth Weight Neonates Born of Preeclamptic Women at Moi Teaching & Referral Hospital, Kenya

“…Similar to our study ndings, other studies have reported birth asphyxia as the leading cause of neonatal morbidity among neonates born of pre-eclamptic women owing to lung immaturity and insu cient surfactant production (21,22,29) . Previous studies have however reported con icting ndings on the impact of hypertension on birth asphyxia (30)(31)(32) .…”

“…About two thirds 107(59.44%) of the LBW neonates were delivered via caesarean section owing to non-reassuring fetal status and worsening preeclampsia or impending eclampsia. The nding is congruent with other studies that have reported caesarian section as the most common mode of delivery among pre-eclamptic women in order to mitigate against adverse perinatal outcomes (21)(22)(23) . The mean APGAR scores for the participants were consistent with other studies that have reported low APGAR scores in LBW neonates at one and ve minutes compared to normal weight neonates [AOR = 0.52 (95%CI: 0.37-0.73), p ≤ 0.001] (24)(25)(26) .…”

Development and evaluation of a nomogram for adverse outcomes of preeclampsia in Chinese pregnant women

“…Premature delivery is a common consequence of preeclampsia [ 35 ]. Premature birth is defined as a live birth at a gestational age < 37 weeks, when the neonatal organ systems are immature, which is one of the main reasons for the increased risk of perinatal and infant morbidity and mortality [ 36 ].…”

The Impact of Coexisting Gestational Diabetes Mellitus on the Course of Preeclampsia

“…Additionally, the rate of small-for-gestational-age (SGA) babies was greater in patients with HDP with and without GDM in comparison to the control group, with an adjusted OR of 6.57 (95% CI 5.56–7.75) and 5.81 (95% CI 5.15–6.55), respectively. The incidence of adverse outcomes increased further in women with PE and eclampsia [ 26 ]. Our results contradict these results, because in our research, the incidence of preterm birth and FGR was lower in patients with PE and coexisting GDM than in women with PE alone.…”

“…To our best knowledge, there is only one study referring to the impact of GDM on the course of pregnancy complicated by hypertensive disorders indicating an increased risk of adverse pregnancy outcomes in women with both gestational hypertension (GH) and GDM [ 26 ]. There is also another study comparing PE biomarkers in patients with PE alone, PE+GDM, GDM alone, and healthy controls demonstrating that sFlt-1 overproduction is also related to PE in GDM pregnancies, even though it is characterized by a less severe endothelial dysfunction [ 21 ].…”