Does pregnancy increase the risk for development and progression of diabetic nephropathy?

M. Miodovnik, B. M. Rosenn, J. C. Khoury, J. L. Grigsby, T. A. Siddiqi, O. Langer, J. M. Roberts, P. G. McDonough, S. G. Gabbe, J. A. Spinnato

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Abstract

OBJECTIVE: This study was designed to determine whether pregnancy and increasing parity in women with insulin-dependent diabetes mellitus (1) increases the risk for diabetic nephropathy and (2) accelerates the progression of diabetic nephropathy. STUDY DESIGN: The study included women with insulin-dependent diabetes mellitus who enrolled in our diabetes-in- pregnancy trial with a pregnancy that continued beyond 20 weeks' gestation and who were delivered between 1978 and December 31, 1991, to allow for a minimum of 3 years' follow-up. Pregnancy and follow-up information was obtained from the medical records and from our computerized database. For patients followed up elsewhere, information was obtained from their current physicians. Life-table analysis was used to determine (1) the risk for nephropathy developing de novo as a function of duration of disease and the association of this risk with parity and (2) the risk of renal failure developing in women with preexisting nephropathy and its association with parity. RESULTS: The study population included 182 pregnant women with insulin-dependent diabetes mellitus: 46 with overt nephropathy (group F) and 136 without nephropathy (group NF). Pregnancy and increasing parity did not increase the overall risk for nephropathy (44% after 27 years of diabetes). In group NF 10% had nephropathy within 10.1 ± 4.2 years of the pregnancy. Proteinuria appearing during pregnancy and glycemic control during pregnancy were significantly associated with the subsequent development of nephropathy. In group F 26% had end-stage renal disease after a median period of 6 years from the pregnancy. Pregnancy or increasing parity did not increase the risk for renal failure in women with nephropathy. CONCLUSIONS: Our data support the premise that pregnancy in women with insulin-dependent diabetes mellitus does not increase the risk of subsequent nephropathy and does not accelerate progression of renal disease in women with preexisting nephropathy.

Original languageEnglish (US)
Pages (from-to)1180-1191
Number of pages12
JournalAmerican Journal of Obstetrics and Gynecology
Volume174
Issue number4
DOIs
StatePublished - Jan 1 1996

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Diabetic Nephropathies
Pregnancy
Parity
Type 1 Diabetes Mellitus
Renal Insufficiency
Computerized Medical Records Systems
Pregnancy in Diabetics
Life Tables
Proteinuria
Chronic Kidney Failure
Disease Progression
Pregnant Women
Databases
Physicians
Kidney

Keywords

  • diabetic nephropathy
  • Insulin-dependent diabetes
  • pregnancy

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Miodovnik, M., Rosenn, B. M., Khoury, J. C., Grigsby, J. L., Siddiqi, T. A., Langer, O., ... Spinnato, J. A. (1996). Does pregnancy increase the risk for development and progression of diabetic nephropathy? American Journal of Obstetrics and Gynecology, 174(4), 1180-1191. https://doi.org/10.1016/S0002-9378(96)70660-9

Does pregnancy increase the risk for development and progression of diabetic nephropathy? / Miodovnik, M.; Rosenn, B. M.; Khoury, J. C.; Grigsby, J. L.; Siddiqi, T. A.; Langer, O.; Roberts, J. M.; McDonough, P. G.; Gabbe, S. G.; Spinnato, J. A.

In: American Journal of Obstetrics and Gynecology, Vol. 174, No. 4, 01.01.1996, p. 1180-1191.

Research output: Contribution to journalArticle

Miodovnik, M, Rosenn, BM, Khoury, JC, Grigsby, JL, Siddiqi, TA, Langer, O, Roberts, JM, McDonough, PG, Gabbe, SG & Spinnato, JA 1996, 'Does pregnancy increase the risk for development and progression of diabetic nephropathy?', American Journal of Obstetrics and Gynecology, vol. 174, no. 4, pp. 1180-1191. https://doi.org/10.1016/S0002-9378(96)70660-9
Miodovnik, M. ; Rosenn, B. M. ; Khoury, J. C. ; Grigsby, J. L. ; Siddiqi, T. A. ; Langer, O. ; Roberts, J. M. ; McDonough, P. G. ; Gabbe, S. G. ; Spinnato, J. A. / Does pregnancy increase the risk for development and progression of diabetic nephropathy?. In: American Journal of Obstetrics and Gynecology. 1996 ; Vol. 174, No. 4. pp. 1180-1191.
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abstract = "OBJECTIVE: This study was designed to determine whether pregnancy and increasing parity in women with insulin-dependent diabetes mellitus (1) increases the risk for diabetic nephropathy and (2) accelerates the progression of diabetic nephropathy. STUDY DESIGN: The study included women with insulin-dependent diabetes mellitus who enrolled in our diabetes-in- pregnancy trial with a pregnancy that continued beyond 20 weeks' gestation and who were delivered between 1978 and December 31, 1991, to allow for a minimum of 3 years' follow-up. Pregnancy and follow-up information was obtained from the medical records and from our computerized database. For patients followed up elsewhere, information was obtained from their current physicians. Life-table analysis was used to determine (1) the risk for nephropathy developing de novo as a function of duration of disease and the association of this risk with parity and (2) the risk of renal failure developing in women with preexisting nephropathy and its association with parity. RESULTS: The study population included 182 pregnant women with insulin-dependent diabetes mellitus: 46 with overt nephropathy (group F) and 136 without nephropathy (group NF). Pregnancy and increasing parity did not increase the overall risk for nephropathy (44{\%} after 27 years of diabetes). In group NF 10{\%} had nephropathy within 10.1 ± 4.2 years of the pregnancy. Proteinuria appearing during pregnancy and glycemic control during pregnancy were significantly associated with the subsequent development of nephropathy. In group F 26{\%} had end-stage renal disease after a median period of 6 years from the pregnancy. Pregnancy or increasing parity did not increase the risk for renal failure in women with nephropathy. CONCLUSIONS: Our data support the premise that pregnancy in women with insulin-dependent diabetes mellitus does not increase the risk of subsequent nephropathy and does not accelerate progression of renal disease in women with preexisting nephropathy.",
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N2 - OBJECTIVE: This study was designed to determine whether pregnancy and increasing parity in women with insulin-dependent diabetes mellitus (1) increases the risk for diabetic nephropathy and (2) accelerates the progression of diabetic nephropathy. STUDY DESIGN: The study included women with insulin-dependent diabetes mellitus who enrolled in our diabetes-in- pregnancy trial with a pregnancy that continued beyond 20 weeks' gestation and who were delivered between 1978 and December 31, 1991, to allow for a minimum of 3 years' follow-up. Pregnancy and follow-up information was obtained from the medical records and from our computerized database. For patients followed up elsewhere, information was obtained from their current physicians. Life-table analysis was used to determine (1) the risk for nephropathy developing de novo as a function of duration of disease and the association of this risk with parity and (2) the risk of renal failure developing in women with preexisting nephropathy and its association with parity. RESULTS: The study population included 182 pregnant women with insulin-dependent diabetes mellitus: 46 with overt nephropathy (group F) and 136 without nephropathy (group NF). Pregnancy and increasing parity did not increase the overall risk for nephropathy (44% after 27 years of diabetes). In group NF 10% had nephropathy within 10.1 ± 4.2 years of the pregnancy. Proteinuria appearing during pregnancy and glycemic control during pregnancy were significantly associated with the subsequent development of nephropathy. In group F 26% had end-stage renal disease after a median period of 6 years from the pregnancy. Pregnancy or increasing parity did not increase the risk for renal failure in women with nephropathy. CONCLUSIONS: Our data support the premise that pregnancy in women with insulin-dependent diabetes mellitus does not increase the risk of subsequent nephropathy and does not accelerate progression of renal disease in women with preexisting nephropathy.

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