Are adverse pregnancy outcomes risk factors for development of end-stage renal disease in women with diabetes?
BACKGROUND
It is unknown whether adverse pregnancy-related outcomes in women with pregestational diabetes are associated with later development of end-stage renal disease (ESRD) or death.


METHODS
We linked data from the Medical Birth Registry of Norway with data from the Norwegian Renal Registry and the Norwegian Cause of Death Registry. Data from up to three pregnancies for women with a first singleton delivery from 1967 to 1994 were included and analysed in a cohort design using Cox regression.


RESULTS
Altogether, 639,018 women were included in the analyses, among whom 2204 women had diabetes mellitus before pregnancy. Their first pregnancy was complicated by pre-eclampsia in 13.2%, low birth weight offspring (<2.5 kg) in 11.0% and preterm birth in 25.1%, and their risk of ESRD and death in the follow-up period of up to 37 years was markedly higher. In women with pregestational diabetes, pre-eclampsia and preterm birth were associated with significantly increased risks of ESRD and death in women with only one pregnancy, but not in women with two or more pregnancies.


CONCLUSIONS
In women with pregestational diabetes, pre-eclampsia and preterm birth were associated with long-term increased risk of ESRD and death, but only in women who had only one pregnancy.
Sandvik
Miriam K
MK
Renal Research Group, Institute of Medicine, University of Bergen, Bergen, Norway. miriam.sandvik@med.uib.no
Iversen
Bjarne M
BM
Irgens
Lorentz M
LM
Skjaerven
Rolv
R
Leivestad
Torbjørn
T
Søfteland
Eirik
E
Vikse
Bjørn Egil
BE
D003928:Diabetic Nephropathies / Q000209:etiology* / Q000401:mortality; D004730:Endothelium, Vascular / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology*; D011225:Pre-Eclampsia; D011247:Pregnancy; D011254:Pregnancy in Diabetics; D047928:Premature Birth; D012307:Risk Factors