Is early-pregnancy proteinuria associated with an increased rate of preeclampsia in women with pregestational diabetes mellitus?
OBJECTIVE
The purpose of this study was to determine whether the rate of preeclampsia in pregnant diabetic women is increased in those women with early-pregnancy proteinuria of 190 to 499 mg/24 hours compared with women with proteinuria of <190 mg/24 hours.


METHODS
Secondary analysis was performed with relevant data from 194 pregnant women with type 1 and type 2 diabetes mellitus whose condition required insulin and who were enrolled previously in a multicenter trial of low-dose aspirin for the prevention of preeclampsia. The women were assigned to 1 of 3 groups, based on the level of proteinuria at enrollment (13-26 weeks of gestation). Group 1 comprised women with <190 mg protein/24 hours (n=94); group 2 comprised women with 190 to 499 mg protein/24 hours (n=35); and group 3 comprised women with >/=500 mg protein/24 hours (n=65). The rate of preeclampsia, according to strict predefined criteria, was then determined.


RESULTS
The rate of preeclampsia was not increased statistically significantly in patients with early-pregnancy proteinuria of 190 to 499 mg/24 hours (7/35 women; 20%) when compared with women with proteinuria of <190 mg/24 hours (16/94 women; 17%).


CONCLUSIONS
We did not find an increased rate of preeclampsia in women with pregestational diabetes mellitus with early-pregnancy proteinuria of 190 to 499 mg/24 hours when compared with women with pregestational diabetes mellitus with proteinuria of <190 mg/24 hours.
How
Helen Y
HY
National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units, Bethesda, MD, USA.
Sibai
Baha
B
Lindheimer
Marshall
M
Caritis
Steve
S
Hauth
John
J
Klebanoff
Mark
M
Macpherson
Cora
C
Van Dorsten
Peter
P
Miodovnik
Menachem
M
Landon
Mark
M
Paul
Richard
R
Meis
Paul
P
Thurnau
Gary
G
Dombrowski
Mitchell
M
Roberts
James
J
D000328:Adult; D005260:Female; D006801:Humans; D015994:Incidence; D011225:Pre-Eclampsia / Q000150:complications* / Q000453:epidemiology*; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011254:Pregnancy in Diabetics / Q000150:complications*; D011507:Proteinuria / Q000150:complications* / Q000503:physiopathology; D012720:Severity of Illness Index