Studying the Maternal and Neonatal Outcomes in Pregnancies Complicated by Diabetes and Hypertension in the State of Qatar-Retrospective Study

Background

Diabetes mellitus (DM) and hypertension (HTN) in pregnancy are one of the common cause of maternal and neonatal mortality and morbidity. The purpose of this study was to evaluate the impact of DM and HTN in pregnancy on maternal and neonatal outcomes in the state if Qatar.

Method

A retrospective population-based cohort study including 15,428 singleton deliveries during the 2017 year was carried out. Maternal health was stratified into three groups. The first group included women with DM (pre-gestational diabetes mellitus (Pre-DM) and gestational diabetes mellitus (GD)), the second group included women with HTN (Essential HTN (E HTN), Gestational HTN (GHTN), and pre-eclampsia/eclampsia), and the third group included women with no DM and no HTN (healthy controls). Maternal and neonatal outcomes data were obtained from the Pearl Peristat registry. One way ANOVA, with post hoc Bonferroni, and chi-square analyses were performed using SPSS v24.1 software.

Results

The prevalence of DM in pregnancy was found to be 28.5% (N: 4,401), GDM 26.2% (N: 4,044) and pre-GDM 2.3% (N: 358). Of total population 1,368 (35.7%) women had cesarean sections delivery. Diabetes in pregnancy was significantly associated with higher neonatal birth weight (p<0.013), and macrosomia (p<0.002) and neonates of mothers with DM had significantly more admissions to the intensive care unit (NICU) (p<.001). On the other hand, the prevalence of HTN was 5.4% (N: 831) (E-HTN: 1.1%; N: 177; G-HTN: 2.0%; N: 301; pre-eclampsia eclampsia: 2,3%; N: 353). Cesarean section and preterm delivery were found to be significantly higher in women with HTN than controls (p<.001) and neonates of women with HTN had significantly lower birth weight (p<001), lower Apgar score at 5 min (p<.003), and more frequent admissions to NICU (p<.001) compared to controls. No significant association was found between stillborn births and DM and HTN disorders in pregnancy.

Conclusion

Our study confirms that both DM and HTN in pregnancy were significantly associated with maternal and neonatal adverse outcomes.