Correlation of Insulin Resistance and sensitivity in Pregnancy with Obstetric and Neonatal Outcomes: A Pilot Observational Study
Harshita Tanwar
Department of Obstetrics and Gynaecology, AIIMS New Delhi, India.
Rajesh Kumari *
Department of Obstetrics and Gynaecology, AIIMS New Delhi, India.
Yashdeep Gupta
Department of Endocrinology and Metabolism, AIIMS New Delhi, India.
Anubhuti Rana
Department of Obstetrics and Gynaecology, AIIMS New Delhi, India.
Anju Singh
Department of Obstetrics and Gynaecology, AIIMS New Delhi, India.
Archana Kumari
Department of Obstetrics and Gynaecology, AIIMS New Delhi, India.
Neha Varun
Department of Obstetrics and Gynaecology, AIIMS New Delhi, India.
Garima Kachhawa
Department of Obstetrics and Gynaecology, AIIMS New Delhi, India.
Reeta Mahey
Department of Obstetrics and Gynaecology, AIIMS New Delhi, India.
JB Sharma
Department of Obstetrics and Gynaecology, AIIMS New Delhi, India.
Neerja Bhatla
Department of Obstetrics and Gynaecology, AIIMS New Delhi, India.
*Author to whom correspondence should be addressed.
Abstract
Aims and Objectives: To assess insulin resistance and sensitivity during pregnancy and to find their correlation with maternal and fetal outcomes.
Materials and Methods: A two-year prospective observational study at All India Institute of Medical Sciences, New Delhi, enrolled 154 pregnant women, following 113 until delivery. Insulin resistance was assessed twice using HOMA IR and HOMA-β, and GDM was tested by Oral glucose tolerance test (OGTT).
Results: In our study, 17.7% of women were diagnosed with GDM. Significant correlations were found between BMI and insulin resistance (p=0.001), and family history of diabetes and insulin resistance (p=0.001). HOMA-IR ≥2.5 at 24-28 weeks increased the likelihood of GDM (p=0.014), preeclampsia (p=0.043), and caesarean sections (p=0.009). HOMA-IR <2.5 indicated healthier pregnancies (p=0.034). HOMA-β ≤184.1 was linked to adverse fetal outcomes and NICU admissions (p=0.012).
Conclusions: Optimizing BMI before pregnancy reduces risks like GDM, preeclampsia, NICU admissions, and neonatal hypoglycemia. Promote lifestyle, diet, exercise, and weight control awareness.
Keywords: Insulin resistance, insulin sensitivity, HOMA-IR, HOMA- β, GDM