Hypertension and the pregnancy complicated by diabetes
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Diabetes is a frequent complication of pregnancy. Type 1 diabetes is associated with an increased incidence of preeclampsia and pregnancy-induced hypertension. When renal dysfunction is present, the incidence of these complications is remarkably increased. White's class, poor glycemic control during the first half of pregnancy, and early blood pressure elevation are also independent risk factors for developing preeclampsia. Whether gestational diabetes increases the background incidence of preeclampsia is still debated. Because therapeutic interventions such as low-dose aspirin and antioxidants have not been shown to be effective, preventive measures rely on tight blood glucose control, as well as adequate blood pressure treatment.
- Conquering Diabetes. A Strategic Plan for the 21st Century. A report of the congressionally established diabetes research working group 1999. NIH publication No. 99- 4398. http://www.niddk.nih.gov/federal/dwg/fr.pdf.
- ACOG Committee on Practice Bulletins: ACOG Practice Bulletin. Clinical Management Guidelines for Obstetrician-Gynecologists. Number 60, March 2005. Pregestational diabetes mellitus. Obstet Gynecol 2005, 105:675–685.
- American Diabetes Association: Gestational diabetes mellitus. Diabetes Care 2004, 27(suppl 1):S88-S90.
- Brody SC, Harris R, Lohr K: Screening for gestational diabetes: a summary of the evidence for the U.S. Preventive Services Task Force. Obstet Gynecol 2003, 101:380–392. CrossRef
- Bernasko J: Contemporary management of type 1 diabetes mellitus in pregnancy. Obstet Gynecol Surv 2004, 59:628–636. CrossRef
- Hiilesmaa V, Suhonen L, Teramo K: Glycaemic control is associated with pre-eclampsia but not with pregnancyinduced hypertension in women with type I diabetes mellitus. Diabetologia 2000, 43:1534–1539. CrossRef
- Hanson U, Persson B: Epidemiology of pregnancy-induced hypertension and preeclampsia in type I (insulin-dependent) diabetic pregnancies in Sweden. Acta Obstet Gynecol Scand 1998, 77:620–624. CrossRef
- Miodovnik M, Rosenn BM, Khoury JC, et al.: Does pregnancy increase the risk for development and progression of diabetic nephropathy? Am J Obstet Gynecol 1996, 74:1180–1189; discussion 1189–1191. CrossRef
- Sibai BM, Caritis S, Hauth J, et al.: Risks of preeclampsia and adverse neonatal outcomes among women with pregestational diabetes mellitus. National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units. Am J Obstet Gynecol 2000, 182:364–369. CrossRef
- Combs CA, Rosenn B, Kitzmiller JL, et al.: Early-pregnancy proteinuria in diabetes related to preeclampsia. Obstet Gynecol 1993, 82:802–807.
- Reece EA, Coustan DR, Hayslett, et al.: Diabetic nephropathy: pregnancy performance and fetomaternal outcomes. Am J Obstet Gynecol 1988, 159:56–66.
- Kimmerle R, Zass RP: Pregnancies in women with diabetic nephropathy: long-term outcome for mother and child. Diabetologia 1995, 38:227–235.
- Gordon M, Landon MB, Samuels P, et al.: Perinatal outcome and long-term follow-up associated with modern management of diabetic nephropathy. Obstet Gynecol 1996, 87:401–409. CrossRef
- Reece EA, Leguizamon G, Homko C: Pregnancy performance and outcomes associated with diabetic nephropathy. Am J Perinatol 1998, 15:413–421.
- Sibai BM: Risk factors, pregnancy complications, and prevention of hypertensive disorders in women with pregravid diabetes mellitus. J Matern Fetal Med 2000, 9:62–65. A review of the rate, risk factors, and potential prevention of preeclampsia in women with PGDM. CrossRef
- Cousins L: Obstetric complications in diabetic pregnancies. In Diabetes in Women. Adolescence, Pregnancy, and Menopause. Edited by Reece EA, et al. Philadelphia: Lippincott, Williams, & Wilkins; 2004:351–362.
- Cousins LM: Pregnancy complications among diabetic women: review 1965–1985. Obstet Gynecol Surv 1987, 42:140–147.
- Garner PR, D'Alton ME, Dudley DK, et al.: Preeclampsia in diabetic pregnancies. Am J Obstet Gynecol 1990, 163:505–508.
- Siddiqi T, Rosenn B, Mimouni F, et al.: Hypertension during pregnancy in insulin-dependent diabetic women. Obstet Gynecol 1991, 77:514–519.
- Rudge M, Calderon I, Ramos M, et al.: Hypertensive disorders in pregnant women with diabetes mellitus. Gynecol Obstet Invest 1997, 44:11–15. CrossRef
- Cundy T, Slee F, Gamble G, et al.: Hypertensive disorders of pregnancy in women with type 1 and type 2 diabetes. Diabet Med 2002, 19:482–489. CrossRef
- Leguizamon G, Reece EA: Effect of medical therapy on progressive nephropathy: influence of pregnancy, diabetes and hypertension. J Matern Fetal Med 2000, 9:70–78. CrossRef
- Ritz E, Orth SR: Nephropathy in patients with type 2 diabetes mellitus. N Engl J Med 1999, 341:1127–1133. CrossRef
- Kitzmiller JL, Brown ER, Phillippe M, et al.: Diabetic nephropathy and perinatal outcome. Am J Obstet Gynecol 1981, 141:741–751.
- Reece EA, Leguizamon GF, Homko C: Stringent controls in diabetic nephropathy associated with optimisation of pregnancy outcomes. J Matern Fetal Med 1998, 7:213–216. CrossRef
- Ekbom P, Damm P, Feldt-Rasmussen B, et al.: Pregnancy outcome in type 1 diabetic women with microalbuminuria. Diabetes Care 2001, 24:1739–1744. CrossRef
- How HY, Sibai B, Lindheimer M, et al.: Is early-pregnancy proteinuria associated with an increased rate of preeclampsia in women with pregestational diabetes mellitus? Am J Obstet Gynecol 2004, 190:775–778. CrossRef
- Hsu CD, Hong SF, Nickless NA, Copel JA: Glycosylated hemoglobin in insulin-dependent diabetes mellitus related to preeclampsia. Am J Perinatol 1998, 15:199–202.
- Wang Y, Walsh SW: Antioxidant activities and mRNA expression of superoxide dismutase, catalase, and glutathione peroxidase in normal and preeclamptic placentas. J Soc Gynecol Investig 1996, 3:179–84. CrossRef
- Giugliano D, Ceriello A, Paolisso G: Oxidative stress and diabetic vascular complications. Diabetes Care 1996, 19:257–267. CrossRef
- Arauz-Pacheco C, Parrott MA, Raskin P: Treatment of hypertension in adults with diabetes. Diabetes Care 2003, 26(supp 1): S80-S82.
- Caritis S, Sibai B, Hauth J, et al.: Predictors of pre-eclampsia in women at high risk. National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units. Am J Obstet Gynecol 1998, 179:946–951. CrossRef
- Duckitt K, Harrington D: Risk factors for pre-eclampsia at antenatal booking: systematic review of controlled studies. BMJ 2005, 330:565. CrossRef
- Lauszus FF, Rasmussen OW, Lousen T, et al.: Ambulatory blood pressure as predictor of preeclampsia in diabetic pregnancies with respect to urinary albumin excretion rate and glycemic regulation. Acta Obstet Gynecol Scand 2001, 80:1096–1103. CrossRef
- Ekbom P, Damm P, Nogaard K, et al.: Urinary albumin excretion and 24-hour blood pressure as predictors of pre-eclampsia in type I diabetes. Diabetologia 2000, 43:927–931. CrossRef
- Vambergue A, Nuttens MC, Goeusse P, et al.: Pregnancy induced hypertension in women with gestational carbohydrate intolerance: the diagest study. Eur J Obstet Gynecol Reprod Biol 2002, 102:31–35. This study compared the incidence of PIH in three groups according to different gestational glucose intolerance. PIH appears to be linked to the level of glucose intolerance during pregnancy, independently of other known factors of hypertension. CrossRef
- Joffe GM, Esterlitz JR, Levine RJ, et al.: The relationship between abnormal glucose tolerance and hypertensive disorders of pregnancy in healthy nulliparous women. Calcium for Preeclampsia Prevention (CPEP) Study Group. Am J Obstet Gynecol 1998, 179:1032–1037. CrossRef
- Casey BM, Lucas MJ, MCIntire DD, et al.: Pregnancy outcomes in women with gestational diabetes compared with the general obstetric population. Obstet Gynecol 1997, 90:869–873. CrossRef
- Jensen DM, Sorensen B, Feilberg-Jorgensen N, et al.: Maternal and perinatal outcomes in 143 Danish women with gestational diabetes mellitus and 143 controls with a similar risk profile. Diabet Med 2000, 17:281–286. CrossRef
- Schaffir JA, Lockwood CJ, Lapinski R, et al.: Incidence of pregnancy-induced hypertension among gestational diabetics. Am J Perinatol 1995, 12:252–254. CrossRef
- Sermer M, Naylor CD, Gare DJ, et al.: Impact of increasing carbohydrate intolerance on maternal-fetal outcomes in 3637 women without gestational diabetes. The Toronto Tri-Hospital Gestational Diabetes Project. Am J Obstet Gynecol 1995, 173:146–156. CrossRef
- Yogev Y, Xenakis EMJ, Langer O: The association between preeclampsia and the severity of gestational diabetes: the impact of glycemic control. Am J Obstet Gynecol 2004, 191:1655–1660. CrossRef
- Caritis S, Sibai B, Hauth J, et al.: Low-dose aspirin to prevent preeclampsia in women at high risk. National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units. N Engl J Med 1998, 338:701–705. CrossRef
- CLASP: a randomized trial of low-dose aspirin for the prevention and treatment of pre-eclampsia among 9364 pregnancy women. CLASP Collaborative Low Dose Aspirin Study in Pregnancy Collaborative Group [no authors listed]. Lancet 1994, 343:619–629.
- Coomarasamy A, Honest H, Papaioanno S, et al.: Aspirin for prevention of preeclampsia in women with historical risk factors: a systematic review. Obstet Gynecol 2003, 101:1319–1332. CrossRef
- Roberts JM, Gammill HS: Preeclmapsia: recent insights. Hypertension 2005, 46:1243–1249. CrossRef
- Poston L, Brilley AL, Kelly FJ, et al.: Vitamin C and vitamin E in pregnant women at risk for pre-eclampsia (VIP trial): randomized placebo-controlled trial. Available online at http://www.thelancet.com. Accessed March 30, 2006.
- Hypertension and the pregnancy complicated by diabetes
Current Diabetes Reports
Volume 6, Issue 4 , pp 297-304
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