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Diabetic nephropathy in pregnancy - an 18 year experience in a tertiary care centre

Author(s): Rita Serrano dos Anjos

Journal: Acta Obstetrica e Ginecologia Portuguesa
ISSN 1646-5830

Aim: To evaluate the obstetric and neonatal outcomes in pregnant women with diabetic nephropathy.Study Design: Retrospective observational study.Population: A total of 25 pregnant women with diabetic nephropathy attending our fetal-Maternal Unit from 1991 to 2008. Material and Methods: The demographic data, clinical and analytical evolution throughout pregnancy were obtained from clinical records. Data from obstetrical and neonatal outcomes were correlated with creatinine blood levels (above 1,5mg/dL) and glycosylated hemoglobin (above 8,0%) obtained in the first prenatal visit.Results: Twenty-nine single gestations in 25 patients were evaluated. The prevalence of chronic hypertension was 55.2% (n=16), and that of diabetic retonopathy 86.2% (n=25). Spontaneous and therapeutic abortion rates were 10.3% (n=3) and 13.8% (n=4), respectively. In the remaining 22 pregnancies, three cases of congenital malformations and four perinatal deaths occurred. Fetal growth restriction and fetal macrossomia were observed in 18.2% (n=4) and 13.6% (n=3) of pregnancies, respectively. The incidence of preterm labor was 77.3% (n=17), of cesarean section 90.9% (n=20), and of neonatal complications 47.6% (n=10). No significant statistical association between glycosylated hemoglobin or creatinine blood levels and poor obstetric or neonatal outcome was found.Conclusions: Diabetic nephropathy appears to be frequently associated with an unfavourable obstetric and neonatal outcome.
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