All situations of hypertensive disorders and shoulder dystocia underwent masked central review by two of the authors to ensure that the diagnoses had been accurate. Statistical Analysis We reviewed the literature to look for the frequency of each element of the composite result among females with gestational diabetes mellitus who were not really treated for the problem and among those who were treated. It had been assumed that in the group that didn’t receive treatment for mild gestational diabetes mellitus, the rate of perinatal death, hypoglycemia, hyperbilirubinemia, hyperinsulinemia , or birth trauma will be 20 to 30 percent.18-23 Assuming a composite outcome rate in the control group of 25 percent, we calculated that with an example size of 950 , the analysis could have at least 80 percent power to show a 30 percent difference in the composite outcome with treatment, with a sort I error of 5 percent .Dr. Lewis identified self-efficacy, depression, and patient-provider communication among the factors in medicine nonadherence. She needed further study, but advised these factors are important for healthcare providers to consider when dealing with hypertensive African-American sufferers. ‘Increasing blood circulation pressure control takes a comprehensive approach,’ wrote Dr. Lewis. ‘Given that self-efficacy and patient-provider communication are modifiable factors, they could be the concentrate of interventions to increase medication adherence.