Hypertensive disorders in normal/over-weight and obese type 2 diabetic pregnant women.
BACKGROUND
Hypertension is one of the major complications of pregnancy. Its impact in type 2 diabetic pregnant women could be understimated because it is generally evaluated by retrospective studies and as one of the outcome measures.


OBJECTIVE
Our aims were: 1) to evaluate the prevalence of hypertensive disease between type 2 diabetic and normal pregnancies; 2) to relate hypertensive disease to body weight in type 2 diabetic pregnancies; 3) to assess the impact of different types of hypertension on pregnancy outcome in type 2 diabetic women.


METHODS
Seventy-six type 2 diabetic (23 normal-weight, 26 overweight and 27 obese) and sixty normal (43, 15 and 2 respectively; x (2) 0.0001) pregnancies, matched for age and smoking habit. Hypertension was defined as >/=140/90 mmHg and classified in chronic, gestational and pre-eclampsia.


METHODS
Student's t-test, chi (2), simple, and/or multiple and logistic regression analysis were used when appropriate. Odds ratio was calculated for hypertension. p significant <0.05.


RESULTS
The overall prevalence of hypertension was 40.8% (18.4% chronic, 17.1% gestational and 5.3% pre-eclampsia) in type 2 diabetic pregnancies and 10% (8.3% gestational and 1.7% pre-eclampsia) in normal pregnancies (p<0.0001), with an odds ratio of 6.2. All the types of hypertension, significantly chronic, contributed to the higher prevalence. Only in diabetic pregnancies, hypertension was associated with a higher pregestational BMI; whenever BMI increased, chronic and gestational hypertension increased by contrast of pre-eclampsia (chi (2), 0.02). Hypertensive disorders did not affect maternal-fetal outcome.


CONCLUSIONS
The prevalence of hypertension was 40.8% in type 2 diabetic pregnant women whilst it was 10.0% in non diabetic controls. All hypertensive disorders, significantly chronic, were more frequent. Increasing BMI was a crucial factor for chronic and gestational but not for pre-eclampsia. Hypertensive diseases did not seem to affect pregnancy outcome.
Colatrella
A
A
Department of Clinical Sciences, S. Andrea Hospital, 2nd Faculty of Medicine, 'Sapienza' University of Rome, Rome, Italy.
Braucci
S
S
Festa
C
C
Bianchi
P
P
Fallucca
F
F
Mattei
L
L
Trappolini
M
M
Napoli
A
A
D000328:Adult; D015992:Body Mass Index; D016009:Chi-Square Distribution; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology*; D046110:Hypertension, Pregnancy-Induced / Q000453:epidemiology* / Q000209:etiology; D009765:Obesity / Q000150:complications*; D016017:Odds Ratio; D018579:Patient Selection; D011247:Pregnancy; D011256:Pregnancy Outcome; D015995:Prevalence; D011446:Prospective Studies; D012044:Regression Analysis; D012907:Smoking