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Diabetic nephropathy and perinatal outcome

J L Kitzmiller, E R Brown, M Phillippe

    American Journal of Obstetrics and Gynecology
    |December 1, 1981
    PubMed
    Summary

    Pregnancy in women with diabetic nephropathy often worsens proteinuria and hypertension. However, perinatal outcomes have significantly improved, with most infants showing normal development.

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    Area of Science:

    • Obstetrics and Gynecology
    • Nephrology
    • Neonatology

    Background:

    • Diabetic nephropathy poses risks to pregnancy, affecting maternal health and infant outcomes.
    • Understanding the interplay between pregnancy, diabetic nephropathy, maternal hypertension, and renal function is crucial.

    Purpose of the Study:

    • To evaluate the impact of diabetic nephropathy on pregnancy course, perinatal results, and infant development.
    • To assess pregnancy's influence on maternal hypertension and renal function in women with diabetic nephropathy.

    Main Methods:

    • Prospective study analyzing maternal and infant data.
    • Monitoring proteinuria, hypertension, creatinine clearance, and delivery parameters.
    • Assessing infant development through follow-up evaluations.

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    Main Results:

    • Maternal proteinuria increased in 69% and hypertension developed by the third trimester in 73%.
    • Proteinuria declined postpartum in 65%; hypertension resolved in 43.5%.
    • High rates of preterm delivery (71%) and neonatal morbidity were observed, but perinatal survival reached 89%.

    Conclusions:

    • Despite challenges like preterm birth and neonatal morbidity, perinatal outcomes for diabetic women with nephropathy have improved.
    • Infants without congenital anomalies demonstrated normal development.
    • Pregnancy can be managed, leading to better outcomes for both mother and child.