Assessment of pregestational insulin resistance as a risk factor of preeclampsia.
OBJECTIVE
To assess the impact that pregestational insulin resistance (PIR) has as a risk factor for preeclampsia (PE).


METHODS
Nested case-control study that included patients with PIR and a control group that was randomly selected from pregnancies admitted to the Fetal Medicine Unit between January 2005 and May 2011. Clinical and hemodynamic variables were analyzed by a multiple logistic regression analysis.


RESULTS
Of the 13,124 patients admitted during the study period, 119 had a diagnosis of PIR (0.9%). Patients with PIR were older and had a higher body mass index (BMI). PIR was also related to a significantly higher frequency of chronic hypertension (CrHT; 10.1 vs. 2.2%, p < 0.05) and hypothyroidism (5.0 vs. 1.6%, p < 0.05) than in the control group. Moreover, women with PIR were more likely to develop PE (8.4 vs. 4.2%, p < 0.05) and gestational diabetes mellitus (9.2 vs. 2.9%) than the control group. Multivariate analysis showed that maternal age, CrHT and altered uterine artery Doppler sonography during the first and second trimesters were good predictors of PE and that PIR was not.


CONCLUSIONS
Although PIR correlates with PE, conditions related to the latter (CrHT, higher maternal age and increased BMI) may be predominant as risk factors for PE.
Fetal Medicine Unit, University of Chile Hospital, Santiago de Chile, Chile.
Enrique
E
Valdés
Alvaro
A
Sepúlveda-Martínez
Bárbara
B
Manukián
Mauro
M
Parra-Cordero
D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D016022:Case-Control Studies; D002908:Chronic Disease; D016640:Diabetes, Gestational / Q000453:epidemiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D007037:Hypothyroidism / Q000453:epidemiology*; D007333:Insulin Resistance / Q000502:physiology*; D011225:Pre-Eclampsia / Q000453:epidemiology*; D011247:Pregnancy; D011897:Random Allocation; D012307:Risk Factors; D016216:Ultrasonography, Prenatal; D055988:Uterine Artery / Q000000981:diagnostic imaging / Q000503:physiopathology