Abstract
To evaluate birth outcomes in women with hypertensive disorders of pregnancy (HDP) and gestational diabetes mellitus (GDM), we used insurance data of Taiwan to evaluate 11 adverse neonatal outcomes of infants born to women with HDP (N = 7775) and with both HDP and GDM (HDP/GDM) (N = 1946), comparing to women with neither disorder (N = 19,442), matched by age. The impacts of preeclampsia/eclampsia were also evaluated. Results showed that Caesarean section delivery was near 1.7-fold greater in the HDP/GDM and HDP groups than in comparisons. The preterm delivery rates were more than threefold greater in HDP/GDM group and HDP group than in comparisons with adjusted odds ratios (aORs) of 4.84 (95% confidence interval (CI) 4.34–5.40) and 3.92 (95% CI 3.65–4.21), respectively, followed by jaundice (aORs 2.95 (95% CI 2.63–3.33) and 1.90 (95% CI 1.76–2.06)), and small gestation age (SGA) (aORs 6.57 (95% CI 5.56–7.75) and 5.81 (95% CI 5.15–6.55)). Incidence rates of birth trauma, patent ductus arteriosus, atrial septal defect, respiratory distress syndrome, and neonatal hypoglycemia were also higher in the HDP/GDM and HDP groups than in the comparison group. Most adverse outcomes increased further in women with preeclampsia or eclampsia. In conclusion, women with HDP are at elevated risks of adverse neonatal outcomes. Risks of most adverse outcomes increase further for women with both HDP and GDM. Preeclampsia or eclampsia may also contribute to these outcomes to higher risk levels. Every pregnant woman with these conditions deserves specialized prenatal care.
Highlights
To evaluate birth outcomes in women with hypertensive disorders of pregnancy (HDP) and gestational diabetes mellitus (GDM), we used insurance data of Taiwan to evaluate 11 adverse neonatal outcomes of infants born to women with HDP (N = 7775) and with both HDP and GDM (HDP/GDM) (N = 1946), comparing to women with neither disorder (N = 19,442), matched by age
The risks of most adverse outcomes increased to more higher levels in women with preeclampsia or eclampsia developed in the HDP group and HDP/GDM group
We found that children born to women with HDP/GDM had greater incidence adverse neonatal outcomes than children born to women with HDP, except respiratory distress syndrome (RDS)
Summary
Hypertensive disorders of pregnancy (HDP) and gestational diabetes mellitus (GDM) are common disorders that may contribute to complications in pregnant women and newborns. Women with gestational hypertension (GHT) may progress to preeclampsia and eclampsia with proteinuria, edema, and tonic–clonic seizures after 20 weeks of gestation These conditions can trigger acute liver rupture, chronic kidney disease, visual loss, and other maternal c omplications[8,9,10,11,12]. It can pose a higher risk for adverse birth outcomes for the fetus[13,14,15,16,17,18]. Women with HDP or those with both HDP and GDM are at elevated risk for subsequent hypertension and DM after d elivery[33]
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