Shahana Jasmin1, Shakila Nargis2, Nahida Akter3, Shihab Uddin4, Saba Md Rewzanur Rahman5, Jakia Haque6
1. Dr. Shahana Jasmin, Associate Professor, Department Of Biochemistry, Mainamoti Medical College, Cumilla
2. Dr. Shakila Nargis, Associate Professor, Department of gynae and obstetrics, Mainamoti Medical College, Cumilla
3. Dr. Nahida Akter, Associate Professor, Department Of Physiology, North East Medical College, sylhet
4. Dr. Shihab Uddin, Lecturer, Department Of Biochemistry, Mainamoti Medical College, Cumilla
5. Dr. Saba Md Rewzanur Rahman, Associate Profesor, Department of community medicine, Mainamoti Medical College, Cumilla
6. Dr. Jakia Haque, Associate Professor Of Biochemistry, Addin womens Medical College, Dhaka
Abstract
Background: Pregnancy-induced hypertension (PIH), including preeclampsia and eclampsia, is a leading cause of maternal and fetal complications. While the exact cause of PIH remains unclear, insulin resistance has been proposed as a contributing factor due to its role in endothelial dysfunction and vascular abnormalities. Understanding the relationship between insulin resistance and PIH may help to clarify the underlying mechanisms and improve early detection and management of hypertensive disorders in pregnancy.
Objective: To assess the association between insulin resistance and pregnancy- induced hypertension and to compare insulin resistance levels between normotensive pregnant women and those with preeclampsia or eclampsia.
Materials and methods: This cross-sectional study was conducted at Mainamoti Medical College & Hospital, Bangladesh, including 120 pregnant women-60 with preeclampsia/eclampsia and 60 normotensive controls. Participants were over 18 years old, beyond 20 weeks of gestation, and excluded if they had diabetes, chronic kidney disease, autoimmune disorders, thyroid issues, infections, or preexisting hypertension. PIH diagnosis followed ACOG criteria with blood pressure ≥140/90 mm Hg on two readings. Proteinuria was assessed via 24-hour urine collection (300 mg significant). Insulin resistance was measured using HOMA-IR. All subjects underwent clinical and laboratory evaluations, and data were analyzed with SPSS using chi-square and t-tests.
Results: The age distribution was comparable between the two groups, with most participants aged 21-30 years and mean ages of 26.40 ± 3.80 in cases and 25.12 ± 3.63 in controls. A higher percentage of primigravida women were found in the case group (71.7%) compared to controls (51.7%), while multigravida was more common among controls. Gestational age of 26-32 weeks was more frequent in cases (46.7%) than controls (13.3%), whereas 33-38 weeks gestation was more prevalent in controls (86.7%) than cases (53.3%). Fasting insulin and HOMA-IR values were higher in controls ( 12.83 ± 2.41 and 3.21 ± 0.51 ) than in cases ( 5.89 ± 1.46 and 1.36 ± 0.74 ), while fasting blood glucose nearly similar between groups 95.91 ± 9.67 in cases vs. 96.74 ± 17.59 in controls.
Conclusion: This study confirms a significant association between insulin resistance and pregnancy-induced hypertension, with women affected by preeclampsia and eclampsia exhibiting higher insulin resistance compared to normotensive pregnant women.
Key Words: Insulin resistance, pregnancy, induced hypertension.