[Associated factors of pre-eclampsia complicated in pregnant women with abnormal glucose metabolism].

OBJECTIVE: To investigate the incidence and associated factors of pre-eclampsia in women with abnormal glucose metabolism in pregnancy.

METHODS: A retrospective study was conducted on 1202 pregnant women with abnormal glucose metabolism who delivered their babies in our hospital between 1981-2003. All women were divided into 2 groups: group I included 151 women with pre-eclampsia; group II consisted of 1050 women without pre-eclampsia. The risk factors of pre-eclampsia were analyzed.

RESULTS: (1) The incidence of pre-eclampsia was 12.6% as a whole and was 34.8% (39/112), 11.8% (89/753) and 6.8% (23/337) in diabetes mellitus (DM), gestational diabetes mellitus (GDM) and gestational impaired glucose tolerance (GIGT) groups, respectively (P < 0.01). (2) The average pre-pregnant body mass index (BMI), the gestational age at the presence of elevated blood glucose and the parity in group I were significantly different from that of group II [(31 +/- 4) kg/m(2) vs (29 +/- 4) kg/m(2), P = 0.027; (27 +/- 11) weeks vs (30 +/- 7) weeks, P = 0.001; (1.0 +/- 0.6) vs (0.8 +/- 0.6), P = 0.01]. No difference was shown in these two groups in maternal age and gravida. (3) The incidence of pre-eclampsia was increased in women who had poor obstetric history and chronic hypertension (18.5% vs 11.6%, 41.9% vs 11.5%, P = 0.03, 0.000). (4) In group I, the glucose level of glucose challenge test (GCT), oral glucose tolerance test (OGTT, fasting, 2 hr and 3 hr) and the hemoglobin A(1)c (HbA(1)c) value were all higher than those of group II (P = 0.002, 0.000, 0.009, 0.001, 0.004, respectively). (5) Those with insulin treatment had a rate of 15.6% of pre-eclampsia, which was higher than those with diet control (9.9%, P = 0.009), and the glucose not well controlled women had a higher rate of pre-eclampsia than the well controlled ones (17.0% vs 10.0%, P = 0.000). (6) Logistic regression analysis showed that the independent risk factors of pre-eclampsia were pregnant women with chronic hypertension and the level of HbA(1)c.

CONCLUSIONS: Types of abnormal glucose metabolism have significant effect on the incidence of pre-eclampsia. The occurrence of pre-eclampsia in these women is closely related to the plasma glucose level at GDM diagnosis and how well the maternal glucose level is controlled.