Outcome of pregnancy in patients with insulin-dependent diabetes mellitus and nephropathy with moderate renal impairment.
This study examines the effect of pregnancy on fetal outcome and maternal renal function in 17 women with Type 1 diabetes mellitus and nephropathy attending a joint diabetic-antenatal clinic between 1985 and 1993. There were 7 successful pregnancies in 6 women with moderate renal impairment, mean pre-pregnancy serum creatinine 165 mumol l-1 (Group 1), and 12 in 11 women with proteinuria and preserved renal function (Group 2). Median gestation of pregnancy was 31 + 3 weeks in Group 1 and 36 + 4 weeks in Group 2 (p < 0.05). All babies in Group 1 required neonatal intensive care for a median of 19 days (range 8-271) as compared to only 5 of 13 in Group 2 whose median stay was 13 (7-17) days (p < 0.05). There was one late death in Group 1. Longitudinal creatinine data in those with moderate renal impairment suggest no systematic adverse long-term effect of pregnancy on maternal renal function, although differing changes in renal function were observed during pregnancy. The generally favourable outcome achieved relied heavily upon neonatal care expertise.
Mackie
A D
AD
Department of Diabetes, Ipswich Hospital, UK.
Doddridge
M C
MC
Gamsu
H R
HR
Brudenell
J M
JM
Nicolaides
K H
KH
Drury
P L
PL
D000022:Abortion, Spontaneous / Q000453:epidemiology; D000328:Adult; D001724:Birth Weight; D001794:Blood Pressure; D003404:Creatinine / Q000097:blood; D003422:Critical Care; D036861:Delivery, Obstetric; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000503:physiopathology*; D003928:Diabetic Nephropathies / Q000097:blood / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D005919:Glomerular Filtration Rate; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007231:Infant, Newborn; D007668:Kidney / Q000503:physiopathology; D011247:Pregnancy; D011256:Pregnancy Outcome; D011254:Pregnancy in Diabetics; D011507:Proteinuria; D013997:Time Factors
D003404:Creatinine; D006442:Glycated Hemoglobin