Placental pathology and neonatal outcomes in pre-eclampsia with gestational diabetes mellitus

Objective To investigate histopathological placental lesions and adverse neonatal outcomes by Pre-eclampsia (PE) with Gestational Diabetes Mellitus (GDM). Methods This was a retrospective cohort study of pregnancies with PE delivered between 1 January 2012 to 1 January 2014. Pregnant women with PE were recruited, and divided into PE with GDM (PE + GDM) group (n = 278) and PE without GDM (PE - GDM) group (n = 586). We compared the placental pathology and neonatal outcomes between the two groups. Results The (PE + GDM) group was significantly associated with high placenta weight (534.8 +/- 124.1 vs 519.3 +/- 132.3 g,p = .011), the large diameter of the placenta (17.8 +/- 2.2 vs 16.2 +/- 2.7 cm,p = .016) than (PE - GDM) group. The incidence of chorioamnionitis in (PE + GDM) group was significantly higher than (PE - GDM) group [48.9% (136/278) vs 41.5% (243/586),p = .028], whereas there were no significant differences in umbilical cord length and infarction between the two groups. The (PE + GDM) group had a higher rate of prematurity [44.9% (125/278) vs 39.9% (234/586),p = .042] than (PE - GDM) group, in (PE + GDM) group the incidence of LGA [15.1% (42/278) vs 1.0% (6/586),p = .034], RDS [18.7% (52/278) vs 9.2% (54/586),p = .011] and hyperbilirubinemia [10.7% (30/278) vs 1.0% (6/586),p = .038] were higher than (PE - GDM) group. Conclusions GDM increased the offspring's complication in pregnancy with PE, the potential mechanism might be that GDM increased the placenta inflammation.