Endocrine Abstracts

Justification and objectives: Gestational Diabetes Mellitus (GDM) is associated with an increased risk of Pregnancy-Induced Hypertension (PIH). Previous studies suggest a relationship between inflammatory markers and the development of PIH and obstetric and perinatal complications. The aim of the study was to establish the relationship between pro and anti-inflammatory cytokines and the development of PIH and the impact on obstetric and perinatal outcomes.

Material and Methods: From an established prospective cohort of pregnant women with GDM, we studied 11 who developed PIH and 143 who remained normotensive; for reference values, we included 90 healthy non-diabetic normotensive pregnant women. Plasma levels of pro-inflammatory cytokineswere measured at 28–32 weeks of pregnancy, before the clinical onset of PIH. Baseline characteristics, metabolicparameters and obstetric and perinatal outcomes were analyzed.

Results: Higher levels of sFlt-1/PIGF ratio [4.92 ± 2.72 vs 2.27 ± 1.38, P = 0.009] and lower levels of adiponectin [10.09 ± 1.03 vs 12.88 ± 2.74, P = 0.001] were observed in pregnant women with GDM who developed PIH compared to normotensive women with GDM. Higher levels of resistin [7.20 ± 3.02 vs 5.81 ± 3.03, P = 0.001] were observed in pregnant women with GDM compared to control group. We observed lower birth weight [2652.2 ± 638.2 vs 3255 ± 513.4 g, P = 0.011], and higher prevalence of Small for Gestational Age (SGA) newborns [45.5 vs 8.4%, P = 0.003] and Intrauterine Growth Retardation (IGR) [27.3 vs 4.2%, P = 0.018] in pregnant women who developed PIH. Higher rate of hypoglycemia in newborn [27.3 vs 3.5%, P = 0.013] were found in women with PIH compared to normotensive pregnant women.

Conclusions: We concluded that pregnant women with DMG who develop HIE have a characteristic proinflammatory profile, with significantly lower levels of adiponectin and a higher sFlt1/PlGF ratio. This group have a higher rate of adverse pregnancy and neonatal outcome compared to normotensive pregnant women: lower birth weight, a higher incidence of SGA and IGR, and higher prevalence of hypoglycemia in newborn.