Diabetes and Pre-Eclampsia Affecting Pregnancy: A Retrospective Cross-Sectional Study. (April 2018)

• Record Type: Journal Article
• Authors: Kalagiri, Ram R; Vora, Niraj; Wilson, Jessica L; Afroze, Syeda H; Raju, Venkata N; Govande, Vinayak; Beeram, Madhava R; Kuehl, Thomas J; Uddin, Mohammad Nasir
• Is Part Of: Journal of investigative medicine. Volume 66:Number 4(2018)
• Page Start: 728
• Page End: 732
• Publication Date: 2018-04
• Subjects: pregnancy -- diabetes complications; Clinical medicine -- Periodicals; Medicine -- Research -- Periodicals; Medicine; Research -- United States; Clinical medicine; Medicine -- Research; Periodicals; 616.075
• DOI: 10.1136/jim-2017-000537
• Languages: English
• ISSNs: 1081-5589

Abstract

The interaction between pre-eclampsia and diabetes mellitus (DM) is far from being completely understood. In this study, we compared normal pregnancies with those complicated with pre-eclampsia, gestational DM, and/or pre-existing diabetes to assess the effects of hyperglycemia on placental development. AnInstitutional Review Board (IRB) approved retrospective cross-sectional study with 621 subjects was performed. Statistical analysis was performed using Duncan's post hoc test and analysis of variance. Regardless of diabetes status, patients with pre-eclampsia delivered prematurely. Patients in the group with pre-eclampsia and pregestational diabetes delivered much earlier, at 35.0±0.4 weeks, when compared with the patients that had pre-eclampsia with gestational diabetes and pre-eclampsia with no diabetes (*P<0.05 for each). Additionally, patients with pre-existing diabetes who developed pre-eclampsia delivered smaller babies than those with pre-existing diabetes without pre-eclampsia (1.00±0.03, P<0.05 for each). Pre-existing diabetes with added insult of pre-eclampsia led to fetal growth restriction. This outcome validates the understanding that elevated glucose earlier in pregnancy alters placentogenesis and leads to fetal growth restriction.