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Pregnancy outcome of mothers with diabetic nephropathy

Diabetic nephropathy increases risk developing hypertension/ preeclampsia in diabetic mothers and increase perinatal morbidity and mortality rate. The aim of the study was to investigate: 1) incidence of diabetic nephropathy in pregnant women with type-1 diabetes mellitus, 2) frequency of hypertension/preeclampsia in mothers with diabetic nephropathy, 3) perinatal outcome in mothers with diabetic nephropathy. Patients and methods. During the period 1995 to 2004 retrospective analyses of 396 pregnant women with type-1 DM was performed. All patients were divided in five groups: I. pregnancies with type-1 DM without complications (309 ; 78%), II. pregnancies with type-1 DM and non proliferative retinopathy (n=29 ; 7.3%), III. pregnancies with type-1 DM and proliferative retinopathy (n=23 ; 5, 8%), IV. pregnancies with type-1 DM and peripheral neuropathy (n=5 ; 1, 3%), and V. pregnancies with type-1 DM and diabetic nephropathy (n=30 ; 7, 6%). Results. Incidence of diabetic nephropathy was 7.6%. Hypertension/preeclampsia was developed in 14 (47%) of all pregnant type-1 DM patients with diabetic nephropathy, and only in 12% of type-1 DM patients without any complications of diabetes. When the groups were compared for age, height, body weight, gained weight during pregnancy, body mass index, HbA1c values and acid base status of umbilical vein after statistical analyses was found no significant difference. The significant statistical difference was found among diabetic mothers without complications of diabetes and those with diabetic nephropathy when compared to gestational age at delivery, new borns weight and ponderal index. In the group of mothers with diabetic nephropathy preterm delivery rate was significantly higher than in mothers without complications of type-1 DM (p=9.035). Among the mothers with type-1 DM without complications perinatal mortality was 2.8%, and in type-1 DM mothers with diabetic nephropathy perinatal mortality was 0%. Conclusion. Diabetic nephropathy is a serious complication of DM and pregnancies of mothers with such complications have to be closely monitored in order to achieve such good perinatal outcome.

diabetes mellitus; nephropathy; pregnancy; outcome

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