Pregnancy outcome and placental pathology differences in term gestational diabetes with and without hypertensive disorders

Abstract

Objective: To compare pregnancy outcome and placental pathology in pregnancies complicated by gestational diabetes mellitus (GDM A1 and A2), with and without hypertensive disorders.

Methods: Pregnancy outcome and placental pathology from term deliveries of women complicated with GDM with (GDM + H) and without (GDM − H) hypertensive disorders were compared. Results of the GDM + H group were compared also with the non-diabetic patients but with hypertensive disorders (non-GDM + H). Composite neonatal outcome was defined as one or more of early complications: respiratory distress or need of ventilation support, sepsis, phototherapy, transfusion, seizure, hypoxic-ischemic encephalopathy. Placental lesions were categorized to lesions related to maternal and fetal vascular supply abnormalities, and maternal and fetal inflammatory responses.

Results: Of the 192 women with GDM, the GDM + H group (n = 41) were more obese, p < 0.001, with higher rate of placental maternal and fetal vascular supply lesions, p = 0.008, p = 0.03, respectively, but similar neonatal outcome, compared to the GDM − H (n = 151) group. Compared to the non-GDM + H group (n = 41), the GDM + H group had higher birth weights, similar neonatal outcome and similar rate of placental vascular lesions.

Conclusions: Higher rate of placental maternal and fetal vascular supply lesions express underlying placental pathology in women with diabetes and hypertensive disorders, similar to women without DM and with hypertensive complications.

Keywords:

• Gestational diabetes
• hypertension
• placental pathology

Declaration of interest

The authors report no conflict of interest.