The risk of preeclampsia beyond the first pregnancy among women with type 1 diabetes parity and preeclampsia in type 1 diabetes |
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Affiliation: | 1. Department of Obstetrics and Gynecology, San Raffaele Scientific Institute, via Olgettina, 60, 20132 Milan, Italy;2. Department of Medicine, San Raffaele Scientific Institute and Univerisità Vita-Salute, via Olgettina, 60, 20132 Milan, Italy;3. Diabetes Research Institute, San Raffaele Scientific Institute, via Olgettina, 60, 20132 Milan, Italy;1. Institute of Veterinary-Physiology, Freies Universität, Berlin, Germany;2. BioFact Environmental Health Research Center, Lerum, Sweden;3. Department of Obstetrics and Gynaecology, Sahlgrenska Academy, University of Gothenburg, Gothenburg and Södra Älvsborgs Hospital, 501 82 Borås, Sweden;4. Institute for Prevention and Nutrition, Ismaning/Munich, Germany;1. Department of Obstetrics and Gynecology, St. Orsola Malpighi University Hospital, University of Bologna, Bologna, Italy;2. Department of Preventive Pediatric and Neonatology, St. Orsola Malpighi University Hospital, University of Bologna, Bologna, Italy;3. Department of Angiology and Blood Coagulation, St. Orsola Malpighi University Hospital, University of Bologna, Bologna, Italy;1. Núcleo de Pós-Graduação e Pesquisa, Santa Casa de Belo Horizonte, Rua Domingos Vieira 590, Belo Horizonte, MG, Brazil;2. Programa de Pós-Graduação em Ciências Genômicas e Biotecnologia, Universidade Católica de Brasília, SGAN 916, Asa Norte, Brasília, DF 70790-160, Brazil;1. Department of Biochemistry, Lady Hardinge Medical College, New Delhi 110001, India;2. Department of Obstetrics and Gynecology, Lady Hardinge Medical College, New Delhi 110001, India;3. Department of Bioscience, Jamia Milia Islamia, New Delhi 110025, India;1. Department of Surgery, University Medical Center Groningen, Groningen, The Netherlands;2. Department of Surgery, University Medical Center, Utrecht, The Netherlands;3. Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands;4. Department of Surgery, Canisius Wilhelmina Ziekenhuis, Nijmegen, The Netherlands;5. Department of Surgery, University Medical Center St Radboud, Nijmegen, The Netherlands;6. Department of Gastroenterology, St Antonius Hospital, Nieuwegein, The Netherlands |
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Abstract: | AimTo estimate the incidence of preeclampsia (PE) among nulliparous and multiparous patients with type 1 diabetes and to study predictors of PE.MethodsWe prospectively collected data on all pregnancies of patients with pregestational type 1 diabetes, followed at our Prenatal Medicine Unit between 1993 and 2008. Medical records were prospectively reviewed by two obstetricians for maternal demographics, pregnancy data, maternal and fetal outcomes. Data were analyzed according to the development of PE and parity.ResultsWe identified and collected data on 291 eligible pregnancies (195 among nulliparae and 96 among multiparae). The incidence of PE was 9.2% (95% CI: 5.6–14.2) among nulliparae and 9.4% (95% CI: 4.4–17.0) among multiparae. Patients who developed PE had higher HbA1c during pregnancy compared to patients who did not (p = 0.026 among nulliparae and p = 0.032 among multiparae). Chronic hypertension [OR 17.12 (3.22, 91.00)], microalbuminuria at the beginning of the pregnancy [OR 3.77 (1.22, 11.61)], weight gain during pregnancy [OR 1.13 (1.04, 1.23)] and HbA1c in the first trimester [2.81 (1.12, 7.05)], but not parity, were significant predictors of PE.ConclusionsAmong patients with type 1 diabetes the incidence of PE was similar among nulliparae and multiparae, unlikely in the general population where PE is a disease of the first pregnancy. An increased risk of PE should be assumed for both nulliparous and multiparous women with pregestational diabetes. |
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Keywords: | Preeclampsia Diabetes mellitus type 1 Pregnancy |
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