engleski

Good glycemic control reduces the risk of preeclampsia in pregnancies with type I diabetes mellitus

Type 1 diabetes mellitus is associated with an increased risk of preeclampsia. While nephropathy and retinopathy further increase this risk, the relation between glycemic control during pregnancy and preeclampsia is still largely unknown. We followed up 297 consecutive unselected pregnancies with type 1 diabetes mellitus and 324 unselected pregnancies (control group). Glycemic control (HbAlc in early pregnancy and before delivery) and development of preeclampsia (RR >140/90 mmHg accompanied with albuminuria of >0.3 g/L) were assessed. Preeclampsia developed in 18.9% of diabetic pregnancies (excluding those with prepregnancy nephropathy) vs. 3.2% of controls. After adjustment by logistic regression, both the initial HbAlc level and its change during pregnancy remained significant predictors for preeclampsia. The odds for preeclampsia increased by a factor of 1.5 for each 1% increment in the initial HbAlc level, and decreased by a factor of 0.7 for each 1% decrement of HbAlc achieved during pregnancy. We conclude that good glycemic control in women with type I diabetes in early pregnancy reduces the risk of preeclampsia. An improvement of the glycemic control during pregnancy also reduces this risk.

preeclampsia; diabetic pregnancy

nije evidentirano