CHRONIC HYPERTENSION IN GESTATIONAL DIABETES - INFLUENCE ON PREGNANCYOUTCOME

Our objective was to study the influence of chronic hypertension on pr egnancy outcome in women with gestational diabetes (GDM). 418 women wi th GDM (30 with chronic hypertension and 388 nonhypertensives) were re ferred to our diabetes in pregnancy program. All patients were followe d and assessed biweekly until delivery. When hypertensive GDM women (n = 30) wer compared to all nonhypertensive GDM (n = 388), there were s ignificant (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) a nd 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 induc tion prior to onset of spontaneous labor were significantly (p < 0.05) higher in the hypertensive GDM group when compared to the nonhyperten sive GDM. There were no differences with respect to the average blood glucose and frequencies of SGA deliveries. However, when the 30 hypert ensive GDM pregnancies were compared to a control group of 60 nonhyper tensive GDM women matched for age, weight and height, the only signifi cant 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 deliver ies when hypertensive GDM were compared to nonhypertensive GDM women. There were no stillbirths in the entire study population and only 2 ba bies went to the neonatal intensive care unit from the hypertensive mo thers. Hypertensive GDM are more likely to have induction of labor whe n compared to nonhypertensives. The differences in birth weight and LG A between hypertensive GDM and nonhypertensive GDM were no longer obse rved when patients were controlled for age, weight and height index.