Endocrine Abstracts

Gestational diabetes mellitus (GDM) is associated with an increased risk of pregnancy-induced hypertension (PIH). Ambulatory blood pressure monitoring (ABPM) has been used to screen for PIH and preeclampsia in normotensive type 1 diabetic women. To date, there are no data regarding ABPM in women with GDM. The aim of the study was to establish blood pressure (BP) profiles for pregnant with GDM, using ABPM and determine whether a BP pattern can define a population at risk for developing PIH. We analysed the relation between BP profiles and baseline characteristics, metabolic parameters, obstetrics and perinatal complications. We prospectively studied 62 women with GDM recruited at 26–32 weeks of pregnancy. ABPM was carried out for one 24-h period using the SPACELABS 90207 ABP monitor. Four groups based on nocturnal fall pattern: dippers, non-dippers, extreme dippers, and risers. The mean age 34±4.4 years, BMI 27 kg/m² and HbA_1C 5.05%. Forty-five percent had a family history of Type 2 Diabetes; and 33.9% of high BP. The mean systolic/diastolic BP was 107.9/65.7 mmHg. By ABPM, 20 (41.7%) patients were pattern dippers, 2 (4.2%) extreme dippers, 20 (41.7%) non-dippers, and 6 (12.5%) risers. Comparing dipper/non-dippers groups, 24 h microalbuminuria excretion was significantly higher in the dipper group (0.56 vs 2.03 ng/ml, P<0.05). We observed higher levels of night-time diastolic BP in non-dippers (62.9 vs 56.4 mmHg). Fifty-one women delivered to date, 5.8% had preeclampsia and 7.8% PIH. Caesarean delivery in 25% of women and 17.6% macrosomia, without significant differences between groups. We concluded that a higher rate of the non-dippers pattern were observed in women with GDM and it seems to be associated with other factors, such as 24 h microalbuminuria excretion. Thus, higher levels of night-time systolic/diastolic BP could be a useful predictor of PIH. Further studies will be needed to determine the relationships between BP alterations and baseline, metabolic characteristics and obstetrics/perinatal outcomes.