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Maternal overweight and pregnancy outcome in women with Type-1 diabetes mellitus and different degrees of nephropathy
Abstract:Objective.?We aimed to assess the parameters associated with complicated pregnancy in women with Type 1 diabetes mellitus (DM) and nephropathy.

Study design.?A cohort study of 46 consecutive women diagnosed with Type 1 DM with nephropathy prior to pregnancy was included during the years 2000–2007. Complicated pregnancy was defined as one or more of the following: first trimester abortion, superimposed pre-eclampsia, pre-term delivery?<34 weeks, small and large for gestational age neonate, macrosomia, admission to the neonatal intensive care unit and foetal loss (after 22 weeks' gestation).

Results.?Overall, 31/46 (67%) had at least one pregnancy complication. Body mass index (BMI) was the only parameter with a significant difference between the groups, being higher in the women with complicated pregnancy vs. uncomplicated pregnancy (27?±?9 vs. 24?±?3, p?=?0.027). On Multiple logistic regression model in which composite outcome (pregnancy complication) as the dependent variable, pre-pregnancy BMI was the only statistically significant parameter with a difference between the groups (p?=?0.044). No statistical difference was found between the groups in the rate of pre-pregnancy counselling (60% vs. 67%), glycaemic control prior to pregnancy (Hba1c 7.5 vs. 7.1%), the prevalence of patients achieving desired level of glycaemic control (44% vs. 42%), weight gain during pregnancy (12.4 vs. 10.6?kg), duration of DM (18.0 vs. 19.7 years) and proportion of patients treated with angiotensin converting enzyme inhibitors prior to pregnancy (26 vs. 33%).

Conclusion.?Overweight is associated with poor pregnancy outcome in patients with Type-1 DM and different degrees of nephropathy.
Keywords:Type 1 diabetes mellitus  nephropathy  pregnancy  body mass index
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