CHRONIC HYPERTENSION IN GESTATIONAL DIABETES - INFLUENCE ON PREGNANCY OUTCOME

Our objective was to study the influence of chronic hypertension on pregnancy outcome in women with gestational diabetes (GDM). 418 women with GDM (30 with chronic hypertension and 388 nonhypertensives) were referred to our diabetes in pregnancy program. All patients were followed and assessed biweekly until delivery. When hypertensive GDM women (n = 30) wer compared to all nonhypertensive GDM (n = 388), there were significant (p < 0.05) differences in mean maternal age (34 +/- 4.1 vs. 30 +/- 4.6 years), maternal weight (90 + 21.2 vs. 70.6 +/- 14.9 kg) and gestational age at delivery (38.5 +/- 1.2 vs. 39.6 +/- 1.2 weeks). The mean birth weight for the hypertensive GDM group was significantly higher than that of the nonhypertensive GDM (3,360 +/- 578 vs. 3,293 +/- 581 g; p < 0.05). The frequencies of LCA (23.3 vs. 9.8%) and induction prior to onset of spontaneous labor were significantly (p < 0.05) higher in the hypertensive GDM group when compared to the nonhypertensive GDM. There were no differences with respect to the average blood glucose and frequencies of SGA deliveries. However, when the 30 hypertensive GDM pregnancies were compared to a control group of 60 nonhypertensive GDM women matched for age, weight and height, the only significant difference was a higher rate of inductions of labor (36.7 vs. 6.6%, p < 0.05) in hypertensive diabetic women. There were no significant differences in the incidence of LGA, low Apgar scores and SGA deliveries when hypertensive GDM were compared to nonhypertensive GDM women. There were no stillbirths in the entire study population and only 2 babies went to the neonatal intensive care unit from the hypertensive mothers. Hypertensive GDM are more likely to have induction of labor when compared to nonhypertensives. The differences in birth weight and LGA between hypertensive GDM and nonhypertensive GDM were no longer observed when patients were controlled for age, weight and height index.