title: Diabetic nephropathy and microalbuminuria in pregnant women with type 1 and type 2 diabetes: prevalence, antihypertensive strategy, and pregnancy outcome.
abstract: OBJECTIVE
  To evaluate the prevalence of diabetic nephropathy and microalbuminuria in pregnant women with type 2 diabetes in comparison with type 1 diabetes and to describe pregnancy outcomes in these women following the same antihypertensive protocol.
  
  
  METHODS
  Among 220 women with type 2 diabetes and 445 women with type 1 diabetes giving birth from 2007-2012, 41 women had diabetic nephropathy (albumin-creatinine ratio ≥300 mg/g) or microalbuminuria (albumin-creatinine ratio 30-299 mg/g) in early pregnancy. Antihypertensive therapy was initiated if blood pressure ≥135/85 mmHg or albumin-creatinine ratio ≥300 mg/g.
  
  
  RESULTS
  The prevalence of diabetic nephropathy was 2.3% (5 of 220) in women with type 2 diabetes and 2.5% (11 of 445) in women with type 1 diabetes (P = 1.00). The figures for microalbuminuria were 4.5 (10 of 220) vs. 3.4% (15 of 445) (P = 0.39). Baseline glycemic control was comparable between women with type 2 diabetes (n = 15) and type 1 diabetes (n = 26). Blood pressure at baseline was median 128 (range 100-164)/81 (68-91) vs. 132 (100-176)/80 (63-100) mmHg (not significant) and antihypertensive therapy in type 2 versus type 1 diabetes was used in 0 and 62%, respectively, at baseline, increasing to 33 and 96%, respectively, in late pregnancy. Pregnancy outcome was comparable regardless type of diabetes; gestational age at delivery: 259 days (221-276) vs. 257 (184-271) (P = 0.19); birth weight 3,304 g (1,278-3,914) vs. 2,850 (370-4,180) (P = 0.67).
  
  
  CONCLUSIONS
  The prevalence of diabetic nephropathy and microalbuminuria in early pregnancy was similar in type 2 and type 1 diabetes. Antihypertensive therapy was used more frequently in type 1 diabetes. Pregnancy outcome was comparable regardless type of diabetes.
authors.affiliation: Corresponding author: Julie Agner Damm, julie.agner.damm@gmail.com.
authors.forename: Julie Agner
authors.initials: JA
authors.lastname: Damm
authors.forename: Björg
authors.initials: B
authors.lastname: Asbjörnsdóttir
authors.forename: Nicoline Foged
authors.initials: NF
authors.lastname: Callesen
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Mathiesen
authors.forename: Lene
authors.initials: L
authors.lastname: Ringholm
authors.forename: Berit Woetmann
authors.initials: BW
authors.lastname: Pedersen
authors.forename: Elisabeth R
authors.initials: ER
authors.lastname: Mathiesen
mesh_terms: D000328:Adult; D000419:Albuminuria / Q000188:drug therapy / Q000453:epidemiology*; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001786:Blood Glucose; D001794:Blood Pressure; D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000453:epidemiology*; D003928:Diabetic Nephropathies / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D011254:Pregnancy in Diabetics / Q000453:epidemiology*; D015995:Prevalence; D055815:Young Adult
chemical_list: D000959:Antihypertensive Agents; D001786:Blood Glucose