Abstract
Recent studies have shown that pregnancies complicated by hyperglycemia in pregnancy (HIP) and insulin resistance had the highest risk of poor outcomes as compared to normoglycemic pregnancies. This study aimed to determine, only among women with HIP, the characteristics and pregnancy outcomes by increasing insulin resistance. We included from a prospective cohort study 1,423 women with HIP whose insulin resistance was evaluated using the homeostasis model assessment for insulin resistance (HOMA-IR) when HIP care begun. We compared characteristics and pregnancy outcomes by tertiles of HOMA-IR (intertertile range: 1.9 and 3.3). Increasing tertiles of HOMA-IR were positively associated with plasma glucose levels during screening for HIP; preconception BMI; family history of diabetes; previous pregnancy with HIP, macrosomia and hypertensive disorders; and non-European ethnicity (p<0.05 to 0.001). Gestational weight gain was similar but insulin rate increased by tertile of HOMA-IR (tertile 1, 2 and 3: 34.8, 49.0 and 62.7% respectively, p<0.0001). So were Caesarean section (23.5, 26.3 and 32.1%, respectively, p=0.01), pregnancy-induced hypertension (1.3, 3.0 and 6.6%, p<0.0001), preeclampsia (1.5, 3.0 and 4.6% respectively, p<0.05), large-for-gestational-age infant (4.1, 6.4 and 11.2% respectively, p<0.001) and neonatal hypoglycemia (0.6, 1.5 and 3.3% respectively, p<0.01). The risk for large-for-gestational-age infant was higher in women with HOMA-IR in the 3rd tertile as compared to 1st-2nd tertiles (aOR 1.43 [95% confidence interval 1.01-2.03]) in multivariable logistic regression analysis adjusting for BMI, HIP subtypes (early-diagnosed GDM, GDM, diabetes in pregnancy), ethnicity, HOMA-B, parity and gestational weight gain. To conclude, among women with HIP, higher insulin resistance is associated with a more adverse metabolic profile and greater risk of adverse outcomes, although insulin therapy is more often used. Disclosure E. Cosson: None. H. Bihan: None. C. Nachtergaele: None. E. Vicaut: None. M. Sal: None. N. Berkane: None. S. Pinto: None. S. Tatulashvili: None. P. Valensi: None. L. Carbillon: None.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
