Related Experiment Videos
Pregnancy performance and outcomes associated with diabetic nephropathy
E A Reece1, G Leguizamon, C Homko
1Department of Obstetrics, Gynecology and Reproductive Science, Temple University School of Medicine, Philadelphia, Pennsylvania 19140, USA.
American Journal of Perinatology
|October 6, 1998
Summary
Diabetic nephropathy in pregnancy leads to high rates of hypertension, pre-eclampsia, and cesarean deliveries. However, with modern perinatal care, fetal survival is 95%, and pregnancy does not worsen long-term kidney disease progression for most women.
Area of Science:
- Nephrology
- Obstetrics
- Perinatology
Background:
- Diabetic nephropathy is a significant complication of diabetes mellitus.
- Pregnancy in women with diabetic nephropathy presents unique challenges for maternal and fetal health.
- Understanding the impact of pregnancy on renal function and pregnancy outcomes is crucial.
Purpose of the Study:
- To review the world's literature (1981-1996) on the effects of diabetic nephropathy on pregnancy outcomes.
- To examine the impact of pregnancy on renal function in a subpopulation of patients with diabetic nephropathy.
- To analyze maternal and fetal complications and outcomes in this patient group.
Main Methods:
- A Medline Computer System survey of English language literature from 1981 to 1996.
- Analysis of a total patient population of 315, focusing on patient characteristics, clinical management, and maternal/fetal outcomes.
- Statistical correlation analysis of gestational age and birth weight with clinical parameters.
Main Results:
- High incidence of chronic hypertension (42%), pre-eclampsia (41%), and proliferative retinopathy (63%).
- Fetal complications included intrauterine growth restriction (15%), preterm delivery (22%), and congenital malformations (8%); perinatal mortality was 5%.
- Gestational age and birth weight were significantly correlated with proteinuria and blood pressure. Long-term follow-up showed 17% developed end-stage renal disease.
Conclusions:
- Contemporary perinatal care achieves high fetal survival rates (95%) in pregnancies complicated by diabetic nephropathy.
- Pregnancy generally does not accelerate the progression to end-stage renal disease for most women with renal insufficiency.
- While renal function may temporarily decline during gestation, long-term outcomes are often stable.