A registered nurse is educating a newly license nurse about risk factors associated with gestational diabetes mellitus (GDM) and gestational hypertension (GH). The nurse presents four possible risk factors and asks the new nurse to categorize each one correctly. Categorize each risk factor to the appropriate condition. Some risk factors may apply to only one condition, while others may not apply to either

Chronic renal disease. Gestational Hypertension: Pre-existing renal pathology impairs systemic vascular regulation and increases peripheral resistance. Chronic kidney dysfunction often correlates with underlying hypertensive disorders or secondary vascular damage. This physiological strain predisposes the patient to elevated blood pressure during the metabolic demands of pregnancy. Maternal age older than 25. Gestational Diabetes Mellitus: Advanced maternal age starting at 25 increases insulin resistance risk during pregnancy. Pancreatic beta-cell function may decline with age, failing to compensate for placental hormones like human placental lactogen. This threshold is a primary clinical screening indicator for metabolic testing. Maternal age older than 40. Both: Patients over 40 exhibit decreased vascular compliance and higher incidences of baseline endothelial dysfunction. The cardiovascular system faces increased workload, which frequently manifests as hypertension in later maternal years. This age group carries a significantly higher risk profile for preeclampsia development. Even higher risk due to stronger association with impaired glucose tolerance and type 2 diabetes tendencies. Previous birth of an infant that was large gestational age or stillborn. Gestational Diabetes Mellitus: A history of fetal macrosomia suggests prior undiagnosed glucose intolerance or poorly regulated glycemic levels. Stillbirths can occur due to placental insufficiency or metabolic derangements associated with hyperglycemia. This history indicates a high risk for recurrent insulin dysfunction in current pregnancies.