Pre-eclampsia but not pregnancy-induced hypertension is a risk factor for diabetic nephropathy in type 1 diabetic women |
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Authors: | D Gordin V Hiilesmaa J Fagerudd M Rönnback C Forsblom R Kaaja K Teramo P-H Groop FinnDiane Study Group |
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Institution: | 1.Folkh?lsan Research Center, Biomedicum Helsinki,University of Helsinki,Helsinki,Finland;2.Department of Medicine, Division of Nephrology,Helsinki University Central Hospital,Helsinki,Finland;3.Department of Obstetrics and Gynaecology,Helsinki University Central Hospital,Helsinki,Finland |
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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 HbA1c (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.
Electronic supplementary material Supplementary material is available in the online version of this article at and is accessible to authorised users. |
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Keywords: | Coronary heart disease Diabetic nephropathy Pre-eclampsia Pregnancy-induced hypertension Type 1 diabetes |
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