June 2023 · Volume 12 · Issue 6 Page 1763
International Journal of Reproduction, Contraception, Obstetrics and Gynecology
Marandi S et al. Int J Reprod Contracept Obstet Gynecol. 2023 Jun;12(6):1763-1769
www.ijrcog.org
pISSN 2320-1770 | eISSN 2320-1789
Original Research Article
Hypertensive disorders of pregnancy: a manifestation of
insulin resistance
Satyabhama Marandi
1
, Surya D.
1
*, Kabita Chanania
1
, Tapasi Pati
1
, Sibananda Nayak
1
,
Anju Mariam Jacob
1
, Praveen Kumar R.
2
INTRODUCTION
Hypertensive disorders of pregnancy (HDP) is a
complication unique to human pregnancy affecting about
2-8% of pregnant women. It has significant maternal and
neonatal mortality and morbidity.
1
WHO states, HDP
remains a leading cause of direct maternal mortality. It is
associated with abruptio placenta, cerebral haemorrhage,
disseminated intravascular coagulation (DIC), hepatic
failure and renal failure.
Hypertension and/or proteinuria is the leading risk factor
in pregnancy associated with stillbirth. PIH is also
associated with fetal growth restriction (FGR), low birth
weight, respiratory distress syndrome (RDS), cerebral
palsy (CP) and increased admissions to neonatal intensive
care unit.
According to American College of Obstetrics and
Gynecologist (ACOG) and National High Blood Pressure
Education Programme Working Group (NHBPEP) the
DOI: https://dx.doi.org/10.18203/2320-1770.ijrcog20231551
1
Institute of Medical Sciences and SUM Hospital, Bhubaneswar, Odisha, India
2
Department of Radiodiagnosis, Institute of Medical Sciences and SUM Hospital, Bhubaneswar, Odisha, India
Received: 13 April 2023
Accepted: 06 May 2023
*Correspondence:
Dr. Surya D.,
E-mail: suryambbs02@gmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Background: Pregnancy is a unique physiological diabetogenic state characterised by increased insulin resistance that
ensures adequate supply of nutrients to the developing fetus. The insulin sensitivity falls to upto 50 percent in the late
pregnancy. Thus insulin resistance and the resultant hyperinsulinemia are the characteristics features that are evident in
the normal pregnancy during third trimester. In Hypertensive disorders of pregnancy (HDP), there is exacerbation of
the physiological insulin resistance that occurs in normal pregnancy resulting in increased fasting serum insulin level.
Methods: This is a case control study conducted on 90 antenatal women, during the study period of one and half years
(from December 2020 to June 2022) in IMS and SUM Hospital, Bhubaneswar. With informed written consent and after
fulfilling the criterias, 60 normotensive patients were chosen as controls and 30 pregnant patients with hypertensive
disorders of pregnancy were chosen as cases. After 8 hours of overnight fasting, 2ml of blood is drawn and processed
by CMIA technology to detect fasting serum insulin levels. The mean fasting serum insulin levels were compared
between the cases and the controls.
Results: The mean fasting serum insulin level of controls was found to be 9.27 and the mean fasting serum insulin level
of cases was found to be 15.01 which was higher than controls. This was found to be statistically significant with a P
value of 0.000.
Conclusions: Increased fasting serum insulin level is observed in women with HDP than normotensive pregnant
women.
Keywords: CMIA technology, Fasting serum insulin, Hypertensive disorders of pregnancy, Insulin resistance