International journal of Gynecology, Obstetrics and Neonatal Care  (Volume 3 Issue 3)
Maternal Serum Insulin in Hypertensive Disorders of Pregnancy and Neonatal Outcome International journal of Gynecology, Obstetrics and Neonatal Care
Pages 68-73

S. Chhabra, A. Tembhare and V. Agrawal

DOI: http://dx.doi.org/10.15379/2408-9761.2016.03.03.04
Published: 30 November 2016
Abstract

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.

Conclusion: While there was linkage of maternal serum insulin to the severity of HDP, the change in the insulin level affected the perinatal outcome more than the severity of HDP.
Keywords
 Hyperinsulinemia, Neonatal outcome, Hypertension, Hypoglycaemia, Perinatal outcome.
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