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Diabetes and pre-eclampsia affecting pregnancy: a retrospective cross-sectional study
  1. Ram R Kalagiri1,
  2. Niraj Vora1,
  3. Jessica L Wilson2,
  4. Syeda H Afroze3,
  5. Venkata N Raju1,
  6. Vinayak Govande1,
  7. Madhava R Beeram1,2,
  8. Thomas J Kuehl1,2,4,
  9. Mohammad Nasir Uddin5
  1. 1Departments of Pediatrics, Texas A&M Health Science Center College of Medicine, Baylor Scott and White Health, Temple, Texas, USA
  2. 2College of Medicine, Texas A&M Health Science Center College of Medicine, Baylor Scott and White Health, Temple, Texas, USA
  3. 3Department of Medical Physiology, Texas A&M Health Science Center College of Medicine, Baylor Scott and White Health, Temple, Texas, USA
  4. 4Obstetrics and Gynecology, Texas A&M Health Science Center College of Medicine, Baylor Scott and White Health, Temple, Texas, USA
  5. 5Medical Physiology, Texas A&M Health Science Center College of Medicine, Baylor Scott and White Health, Temple, Texas, USA
  1. Correspondence to Dr Ram R Kalagiri, Departments of Pediatrics, Texas A&M Health Science Center College of Medicine, Baylor Scott and White Health, Temple, Texas 76508, USA; Ram.kalagiri{at}bswhealth.org

Abstract

The interaction between pre-eclampsia and diabetes mellitus (DM) is far from being completely understood. In this study, we compared normal pregnancies with those complicated with pre-eclampsia, gestational DM, and/or pre-existing diabetes to assess the effects of hyperglycemia on placental development. AnInstitutional Review Board (IRB) approved retrospective cross-sectional study with 621 subjects was performed. Statistical analysis was performed using Duncan’s post hoc test and analysis of variance. Regardless of diabetes status, patients with pre-eclampsia delivered prematurely. Patients in the group with pre-eclampsia and pregestational diabetes delivered much earlier, at 35.0±0.4 weeks, when compared with the patients that had pre-eclampsia with gestational diabetes and pre-eclampsia with no diabetes (*P<0.05 for each). Additionally, patients with pre-existing diabetes who developed pre-eclampsia delivered smaller babies than those with pre-existing diabetes without pre-eclampsia (1.00±0.03, P<0.05 for each). Pre-existing diabetes with added insult of pre-eclampsia led to fetal growth restriction. This outcome validates the understanding that elevated glucose earlier in pregnancy alters placentogenesis and leads to fetal growth restriction.

  • pregnancy
  • diabetes complications

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Footnotes

  • Contributors RRK, JLW, SHA and MU planned and designed the research proposal. RRK, NV and JLW collected data. TJK helped analyze the data. RRK, NV, JLW, SHA, VNR, VG, MB and MU helped write the manuscript of the research as well as in the editing process.

  • Funding Scott, Sherwood and Brindley Foundation and Children’s Miracle Network Fund (N7854SRES) (MNU) and noble Centennial Endowment for Research in Obstetrics and Gynecology (TJK), Baylor Scott & White Healthcare, Temple, Texas.

  • Competing interests None declared.

  • Ethics approval Baylor Scott and White’s Institutional Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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