Objectives: The aim of the study was to evaluate the incidence of hypertensive disorders in pregnant women affected by type 1 diabetes and the pregnancy outcome in women with or without hypertension. Materials and Methods: one hundred seventy-two pregnancies in 150 women affected by type 1 diabetes were assessed. Twelve pregnancies were excluded (8 pregnancies were excluded because of spontaneous abortions, 1 for voluntary abortion and 3 for twins), so 160 pregnancies were assessed. Middle age was 31.9±5.2. All patients were treated with insulin therapy, 20% with insulin pump and 80% with multi-injective insulin therapy. Results: Twenty-five pregnancies (15.6%) were complicated by hypertensive disorders: 28% by chronic hypertension, 32% by gestational hypertension, 28% by preeclampsia, and 12% preeclampsia superimposed on chronic hypertension. In the patients affected by chronic hypertension the mean week at delivery was 36±3.2, the mean birth weight was 2640.0±875.2 g and the mean birth percentile was 51°±30.46; in the patients affected by gestational hypertension the mean week at delivery was 37.5±1.69, the mean birth weight was 2936.3±566.7 g and the mean birth percentile was 51,2±31.2°; in the pregnancies complicated by preeclampsia, instead, the mean week at delivery was 36,1±2,54, the mean birth weight was 3092,9±1087,42g with a mean birth percentile of 64°±37,2. In the end, in the group of women with preeclampsia superimposed on chronic hypertension the mean week at delivery found was 35.7±2.3, the mean birth weight was 2453.3±525.4g with a percentile of 34.1±8.5. Instead, in the patients affected by type 1 diabetes but without hypertensive disorders the mean week at delivery was 35.6±2.24, the mean birth weight was 3266.0±686.8 g and the mean birth percentile was 58.3 ±28.9. The rate of preterm delivery was 60% in the pregnancies complicated by hypertensive disorders vs 14.1% in the pregnancies without hypertensive complications (p<<0.05). Furthermore, comparing the population with and without hypertensive complications we found significant differences in mean birth weight (p= 0.004) and gestational age at delivery (p<<0.05). Conclusions: as expected, the incidence of hypertensive disorders in pregnancies complicated by type 1 diabetes is higher than in general population. In addition, in our group of study, a poor pregnancy outcome was observed in pregnancies complicated by hypertensive disorders. None statistically significant difference ws observed between the group treated with insulin pump and the group treated with multi- injective insulin therapy.

De Carolis, S., Martino, C., Di Pasquo, E., Santucci, S., Stifani, F., Macri', F., Degennaro, V. A., Ferrazzani, S., Hypertensive disorders in pregnant women affected by type 1 diabetes, Abstract de <<European Congress of the International Society for the Study of Hypertension in Pregnancy>>, (Roma, 05-08 October 2011 ), <<PREGNANCY HYPERTENSION>>, 2011; (1-4): 288-289 [http://hdl.handle.net/10807/12921]

Hypertensive disorders in pregnant women affected by type 1 diabetes

De Carolis, Sara;Martino, Carmelinda;Santucci, Stefania;Stifani, Francesco;Macri', Francesca;Degennaro, Valentina Anna;Ferrazzani, Sergio
2011

Abstract

Objectives: The aim of the study was to evaluate the incidence of hypertensive disorders in pregnant women affected by type 1 diabetes and the pregnancy outcome in women with or without hypertension. Materials and Methods: one hundred seventy-two pregnancies in 150 women affected by type 1 diabetes were assessed. Twelve pregnancies were excluded (8 pregnancies were excluded because of spontaneous abortions, 1 for voluntary abortion and 3 for twins), so 160 pregnancies were assessed. Middle age was 31.9±5.2. All patients were treated with insulin therapy, 20% with insulin pump and 80% with multi-injective insulin therapy. Results: Twenty-five pregnancies (15.6%) were complicated by hypertensive disorders: 28% by chronic hypertension, 32% by gestational hypertension, 28% by preeclampsia, and 12% preeclampsia superimposed on chronic hypertension. In the patients affected by chronic hypertension the mean week at delivery was 36±3.2, the mean birth weight was 2640.0±875.2 g and the mean birth percentile was 51°±30.46; in the patients affected by gestational hypertension the mean week at delivery was 37.5±1.69, the mean birth weight was 2936.3±566.7 g and the mean birth percentile was 51,2±31.2°; in the pregnancies complicated by preeclampsia, instead, the mean week at delivery was 36,1±2,54, the mean birth weight was 3092,9±1087,42g with a mean birth percentile of 64°±37,2. In the end, in the group of women with preeclampsia superimposed on chronic hypertension the mean week at delivery found was 35.7±2.3, the mean birth weight was 2453.3±525.4g with a percentile of 34.1±8.5. Instead, in the patients affected by type 1 diabetes but without hypertensive disorders the mean week at delivery was 35.6±2.24, the mean birth weight was 3266.0±686.8 g and the mean birth percentile was 58.3 ±28.9. The rate of preterm delivery was 60% in the pregnancies complicated by hypertensive disorders vs 14.1% in the pregnancies without hypertensive complications (p<<0.05). Furthermore, comparing the population with and without hypertensive complications we found significant differences in mean birth weight (p= 0.004) and gestational age at delivery (p<<0.05). Conclusions: as expected, the incidence of hypertensive disorders in pregnancies complicated by type 1 diabetes is higher than in general population. In addition, in our group of study, a poor pregnancy outcome was observed in pregnancies complicated by hypertensive disorders. None statistically significant difference ws observed between the group treated with insulin pump and the group treated with multi- injective insulin therapy.
Inglese
De Carolis, S., Martino, C., Di Pasquo, E., Santucci, S., Stifani, F., Macri', F., Degennaro, V. A., Ferrazzani, S., Hypertensive disorders in pregnant women affected by type 1 diabetes, Abstract de <>, (Roma, 05-08 October 2011 ), <>, 2011; (1-4): 288-289 [http://hdl.handle.net/10807/12921]
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