title: [Effect of pregnancy on diabetic vascular complications].
abstract: OBJECTIVE
  There are still controversies referring to pregnancy influence on the development of vascular complications in type 1 diabetes.
  
  
  METHODS
  227 diabetic women were taken into the study (109 who gave at least one birth (GB) and 118, who never were pregnant (NB)). All of patients started to be diabetic before the 15 years of age. We compared the development of vascular complications (VC) (hypertension-RR, proteinuria (P), retinopathy (R) and the age of patients, HbA1C, serum creatinine (Cr), creatinine clearance (CrCl) between the GB and NB groups. We also compared the development of VC in relation to risk factors (RF): HbA1c and duration of diabetes.
  
  
  RESULTS
  Women who gave birth were significantly older and developed diabetes earlier than childless women. We didn't find any significant difference in duration of diabetes, HbA1c, mean blood pressure (BP), Cr and CrCl between these two groups. In the GB group in comparison to NB we noticed higher frequency of RR (11.1% vs 6.8%, OR 1.7), proliferative retinopathy (9% vs 6.8%, OR 1.4) and laser therapy (5.5% vs 3.4%, OR 1.6). In the next step we analyzed the development of VC in relation to risk factors: duration of diabetes (less or more than 20 years) and HbA1c levels (below and above 8.0%). Patients, who developed diabetes before 20 years of age were significantly older (36.3 vs 31.2 years p < 0.001), duration of diabetes in this group was longer (26 vs 14 years p < 0.001), Cr was higher (0.9 mg/dl vs 0.8 mg/dl p < 0.05)and CrCl was lower (73 mg/ml vs 86 mg/ml p < 0.05). In this group the frequency of proteinuria as well as retinopathy were higher (18.2% vs 7.9%, OR 2.59) (52% vs 9.2%, OR 10.6). We didn't find the difference in HbA1c concentration between the groups with different duration of diabetes. Higher HbA1c presented no relation to the age of patients, but correlated with lower frequency of patients without retinopathy (60.3% vs 66% OR 0.68). In this group laser therapy had to be performed more frequent (6.8% vs 1.8% OR 6.1).
  
  
  CONCLUSIONS
  Pregnancy in diabetic patients with good metabolic control doesn't seem to be a risk factor for developing vascular complications. These complications are still strongly correlated with duration of diabetes.
authors.affiliation: Klinika Połoznictwa i Chorób Kobiecych Katedry Ginekologii i Połoznictwa, AM im. K. Marcinkowskiego w Poznaniu. ewaoz@post.pl
authors.forename: Ewa
authors.initials: E
authors.lastname: Wender-Ozegowska
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Zawiejska
authors.forename: Marek
authors.initials: M
authors.lastname: Pietryga
authors.forename: Dorota
authors.initials: D
authors.lastname: Zozulińska
authors.forename: Bogna
authors.initials: B
authors.lastname: Wierusz-Wysocka
authors.forename: Karolina
authors.initials: K
authors.lastname: Chmaj
authors.forename: Romuald
authors.initials: R
authors.lastname: Biczysko
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D003404:Creatinine / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000503:physiopathology; D003930:Diabetic Retinopathy / Q000209:etiology; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D006973:Hypertension / Q000209:etiology; D008423:Maternal Age; D010298:Parity; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000209:etiology* / Q000503:physiopathology; D011254:Pregnancy in Diabetics / Q000150:complications* / Q000503:physiopathology; D011507:Proteinuria / Q000209:etiology; D012307:Risk Factors; D013997:Time Factors
chemical_list: D003404:Creatinine; D006442:Glycated Hemoglobin