S. Chhabra, A. Tembhare and V. Agrawal

Background: Complications of hypertensive disorders, during pregnancy (HDP), labour, postpartum have been recognized for centuries. Focus has shifted from maternal to materno-neonatal outcome, because effects of HDP on maternal metabolism have significant impact on perinatal outcome. Possibility of linkage of hyperinsulinemia leading to hypoglycaemia, growth retardation is real.

Objective: Study was conducted to know relation of maternal serum insulin to the severity of hypertensive disorders and its effects on neonatal outcome.

Material methods: Case control study was carried out over two years. Fasting blood sugar, insulin, post glucose blood sugar were estimated.

Results: Overall 13.32% women who delivered during study period had HDP. Of these 964 women, 609(63.17%) had mild HDP, 12 (1.97%) of them had elevated insulin, 9 (75%) of 12 had LBW, [(2 neonatal deaths, 4(33.33%) still births, 3(25%) admitted to neonatal intensive care NIC)]. Eighty three (8.6%) had severe HDP, 12(14.45%) of them had elevated serum insulin, 8 (66.33%) of 12 had LBW babies (2 NND, 2 still births, one admitted to NIC), significant (p<0.001) difference from 71 with severe HDP with normal insulin. One hundred eight (11.2%) had mild preeclampsia, 21(19.44%) with elevated insulin, [17 (81%) of 21 had LBW babies, 4 (19.04%) NND, 3(14.28%) admitted to NIC, one (4.76%) septicemia. 9 (42.85%) still born, perinatal loss significantly higher (p<0.001), than 87 with mild preeclampsia and normal insulin. One hundred fifteen (11.9%) women had severe PE, 52(45.21%) had elevated serum insulin, 16(30.76%) LBW babies, 13(25%) still births, 13 (25%) babies admitted to NIC, one of 13 (1.92%)died (LBW), difference (significant (p<0.05) from 63 severe PE with normal insulin. Fourty nine (5.08%) women had eclampsia, 24 (48.97%) of them had elevated insulin, of them 7 (29.16%) had LBW, 13(54.16%) still births, 13 (54.16%) admitted to NIC, one (4.16%) NND, significantly more than in 25 with normal insulin (p<0.02). In HDP maternal insulin levels correlated significantly with perinatal outcome irrespective of severity of HDP.