Pre-Gestational Diabetes and Preeclampsia in Bangladeshi Patients: A Retrospective Study

Objective Preeclampsia (PreE) is one of considerable public health threat particularly in developing countries globally affecting approximately 8% of all pregnancies. PreE is a pregnancy-specific condition that increases maternal and infant mortality and morbidity, but the etiology remains unknown. Despite numerous basic, clinical, and epidemiologic studies that have been conducted over the past half century, knowledge of the etiology and pathogenesis of preeclampsia remains elusive. It is diagnosed by new onset increased blood pressure and proteinuria during second or third trimester of gestation; key features of the preeclampsia category include a cut-off blood pressure of 140/90 mm Hg or higher and absolute requirement of proteinuria. Approximately 20% of the diabetic pregnant women develop preE. The mechanisms contributing to this effect is not well characterized. In a recent study, we have shown that hyperglycemia impairs cytotrophoblast (CTB) function via stress signaling. Several researchers demonstrate a direct link between preE and diabetes. The objective of the study was to evaluate potential linkage between the risk of developing preE and the presence of diabetes in pregnant patients in Bangladesh. Methods This is a cross-sectional study of 351 pregnant women performed to evaluate the prevalence of PreE with respect to different risk factors such as previous pregnancy, presence of Antiphospholipid antibodies, pre-existing diabetes (before this pregnancy), multiple gestation / singleton, family history of preE in first degree relative (mother, sister and daughters; most commonly mother), maternal age of 40 or greater. The study was conducted in selected hospitals of Dhaka city, Bangladesh during December 2013 to December 2015. Results The key study findings revealed that the overall rate of development of PreE in Bangladeshi pre-gestational diabetic patients is 22.6 percent. We gave special emphasis on the occurrence of PreE in pre-gestational diabetic patients. Among 351 respondents, 145 Patients (25.5%) with either DM prior to pregnancy or developing gestational diabetes or without diabetes were older (age >35 years) pregnant women (13.1%). Prevalence of PreE is 25.5 (n=145) and 19.6 (n=199) percent among those who developed pre-gestational diabetes and without diabetes prior to pregnancy. Of the respondents 17.2 percent have both systolic and diastolic hypertension those who developed DM prior to this pregnancy and 13 percent among those who does not developed DM prior to this pregnancy. Occurrence of abortion was up to 3 percentage before this pregnancy 45 percentage who developed DM prior to this pregnancy and 35 percent who does not have diabetes among the respondents. Conclusions There is an association has been found between the risk of developing preE and the presence of diabetes in pregnant patients in Bangladesh.