Pre-eclampsia but not pregnancy-induced hypertension is a risk factor for diabetic nephropathy in type 1 diabetic women

Diabetologia. 2007 Mar;50(3):516-22. doi: 10.1007/s00125-006-0544-5. Epub 2007 Jan 10.

Abstract

Aims/hypothesis: Our aim was to study whether pre-eclampsia and pregnancy-induced hypertension are predictors of diabetic nephropathy in type 1 diabetic women.

Materials and methods: A total of 203 type 1 diabetic women, who were pregnant between 1988 and 1996 and followed at the Department of Obstetrics and Gynaecology in Helsinki, were re-assessed after an average of 11 years within the nationwide, multi-centre Finnish Diabetic Nephropathy Study. Diabetic nephropathy was defined as microalbuminuria, macroalbuminuria or end-stage renal disease.

Results: Patients with prior pre-eclampsia had diabetic nephropathy more often than patients with a normotensive pregnancy (diabetic nephropathy vs normal albumin excretion rate: 41.9% vs 8.9%; p<0.001), whereas patients with a history of pregnancy-induced hypertension did not (10.3% vs 8.9%; p=0.81). CHD was more prevalent in patients with a history of pre-eclampsia than in patients with a normotensive pregnancy (12.2% vs. 2.2%; p=0.03). Pre-eclampsia (odds ratio [OR] 7.7, 95% CI 1.6-36.1; p=0.01) and HbA(1c) (OR 2.0, 95% CI 1.1-3.8; p<0.05) were associated with incident diabetic nephropathy even when adjusted for follow-up time, BMI, smoking, diabetes duration and age.

Conclusions/interpretation: These data suggest that a history of pre-eclamptic pregnancy but not pregnancy-induced hypertension is associated with an elevated risk of diabetic nephropathy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Birth Weight
  • Body Mass Index
  • Diabetes Mellitus, Type 1 / complications*
  • Diabetic Nephropathies / epidemiology*
  • Female
  • Glycated Hemoglobin A / analysis
  • Humans
  • Infant, Newborn
  • Pre-Eclampsia / physiopathology*
  • Pregnancy
  • Pregnancy Complications / physiopathology
  • Pregnancy Complications, Cardiovascular / physiopathology*
  • Pregnancy Trimester, Third
  • Risk Factors

Substances

  • Glycated Hemoglobin A