Insulin Resistance in Preeclampsia and Its Effect on Maternal-Fetal Outcomes

Abstract

Aim: It is controversial whether insulin resistance and hyperinsulinemia in preeclamptic patients are due to weight gain during pregnancy or preeclampsia. This research seeks to explore the relationship between insulin resistance and factors such as weight gain, obesity, biochemical indicators, and the fetal outcomes linked to insulin resistance in pregnant women experiencing mild and severe preeclampsia, excluding those with gestational diabetes. Methods: This research was carried out in the Perinatology Department of İzmir Tepecik Training and Research Hospital from July 2013 to January 2014, with the approval of the institution’s ethics committee. Non-diabetic preeclamptic 101 pregnant women between 18 and 44 years of age in 24-40 gestational weeks were involved in the research. We recorded demographic data, biochemical parameters, weight measurements, enquiries regarding glucose metabolism, and data about fetuses. A Homeostatic Model Assessment (HOMA) value of 2.5 or above, along with an insulin sensitivity index of 6 or below, was evaluated as indicative of insulin resistance. Results: There was no remarkable variation in both groups concerning fasting and postprandial glucose level, HOMA-IR (homeostatic model assessment insulin resistance), and insulin sensitivity index. Postprandial insulin levels were significantly elevated in the group with severe preeclampsia (p < 0,05). On the other hand, when we examined the effects on fetal outcomes, delivery time, birth weight, and 1 and 5 min Apgar scores were determined to be statistically significantly lower in the group suffering from severe preeclampsia. Conclusion: In our research, it was observed that postprandial insulin levels were considerably elevated in the group with severe preeclampsia. Postprandial insulin levels can be considered to predict the impact of insulin resistance and sensitivity on disease prognosis and maternal-fetal outcomes in preeclampsia patients without gestational diabetes. Therefore, its usefulness as a parameter for predicting metabolic syndrome in later years should be investigated in large prospective randomized controlled trials. © 2025, Selcuk University. All rights reserved.