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Updated: Mar 21, 2026
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Published on: April 5, 2024
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Diabetes insipidus during pregnancy
1Section of Endocrinology, Diabetes and Nutrition, Boston University School of Medicine/Boston Medical Center, 88 East Newton Street, H-3600, Boston, MA 02118, USA.
Summary
Diabetes insipidus in pregnancy, affecting 1 in 30,000, presents as polyuria and polydipsia. Management varies based on cause, with desmopressin for AVP deficiency and further evaluation for resistance.
Area of Science:
- Obstetrics and Gynecology
- Endocrinology
- Reproductive Medicine
Background:
- Diabetes insipidus (DI) in pregnancy is rare, occurring in approximately 1 in 30,000 pregnancies.
- It can manifest as an exacerbation of pre-existing central or nephrogenic DI, or as a transient form.
- Transient DI of pregnancy arises from increased placental vasopressinase activity, accelerating arginine vasopressin (AVP) metabolism.
Purpose of the Study:
- To review the heterogeneous causes and presentations of DI during pregnancy.
- To discuss the pathophysiology, including the role of placental vasopressinase.
- To outline management strategies based on the underlying DI type.
Main Methods:
- Literature review of DI in pregnancy.
- Analysis of pathophysiology related to placental vasopressinase and AVP metabolism.
- Synthesis of current management guidelines for different DI subtypes.
Main Results:
- DI in pregnancy can be overt or subclinical, central or nephrogenic, or transient due to placental enzymes.
- Transient DI of pregnancy is linked to complications like preeclampsia.
- Management strategies differ: desmopressin (DDAVP) for AVP deficiency, and etiological investigation for AVP resistance.
Conclusions:
- Effective management of DI in pregnancy requires understanding its specific pathophysiology.
- Prompt diagnosis and tailored treatment are crucial for maternal and fetal well-being.
- Further research into the mechanisms and optimal management of DI of pregnancy is warranted.
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