Abstract
INTRODUCTION: It is well established that patients with Gestational Diabetes Mellitus (GDM) are at a greater risk of developing preeclampsia than those not diagnosed with GDM. It has also been shown that nulliparous women are at an increased risk of developing preeclampsia compared to multiparous women. This study investigates the role of parity as a risk factor for preeclampsia in patients already diagnosed with GDM. METHODS: A retrospective chart review was conducted at SUNY Downstate Medical Center. Exact Mantel-Haenszel tests of trend were conducted for the outcome of preeclampsia (yes vs. no) from the following predictors: number of full-term deliveries, number of pre-term deliveries, and number of spontaneous/elective abortions. Step-down Bonferroni corrections to p-values were applied to correct for multiple testing. RESULTS: 636 patients with GDM and no prior history of diabetes were included. The population was composed of 30.3% nulliparous patients with a median age of 31 y/o and 37 weeks 2 days at delivery. The multipara (69.7%) population was similar with a median age of 32 y/o and 37 weeks 2 days at delivery. The results revealed that the frequency of developing preeclampsia in nulliparous women with GDM was more than twice that of multiparous women (8.81 to 4.06, p=0.086). CONCLUSION: As this value was approaching statistical significance, it warrants the necessity of further investigation of nulliparity as a risk factor for preeclampsia in GDM patients. This research was created in the effort to help physicians understand which patients are more at risk for preeclampsia thus aiding in counseling and management.
Published Version
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