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  • 1
    Electronic Resource
    Electronic Resource
    Pregnancies in women with diabetic nephropathy: long-term outcome for mother and child (1995)
    Springer
    Diabetologia 38 (1995), S. 227-235 
    Details
    ISSN: 1432-0428
    Keywords: Diabetes mellitus ; nephropathy ; pregnancy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In order to improve the basis upon which to advise women with diabetic nephropathy about pregnancy, we studied the effect of diabetic nephropathy on the course of pregnancy, perinatal out-come, infant development and long-term outcome of the mothers. All pregnancies of women with diabetic nephropathy (defined as proteinuria 〉400 mg/day (n=26), creatinine clearance 〈80 ml/min and hypertension in the first trimester (n=10)) followed at our centre from 1982 to 1992 were identified (34 White class F and 2 White class T) and the women and their children re-examined in the spring 1993. From the first to the third trimester the percentage of women with proteinuria over 3 g/day increased from 14 to 53% and those treated with anti-hypertensive medication from 53 to 97%. There were no intrauterine or perinatal deaths, but one child died suddenly 4 weeks postpartum. Of 36 new-borns (gestational week at birth 36(3), birth weight 2384(834) g)), 11 were born before week 34 and 8 had respiratory distress syndrome. Renal function in the first trimester, diastolic blood pressure in the third trimester and an HbA1c above normal were predictive of gestational age at delivery and low birth weight (stepwise regression analysis). At follow-up of the children (n=35, age 4.5 (0.4–10) years) the majority (n=27) were normally developed but seven had psychomotor retardation (four of them major). One child had a severe motor retardation due to a congenital anomaly. At follow up, 21 of the 29 mothers had preserved renal function (creatinine 1.3 (0.8–4.3) mg/dl and 8 had developed end stage renal disease and required dialysis (2 of whom were White class T) within 3 (1–9) years postpartum. Of those, 4 women (3 White F and 1 White T) had died. Pregnancy did not seem to specifically accelerate the rate of decline of renal function. In women with diabetic nephropathy perinatal mortality can be prevented but perinatal and long-term infant morbidity remains elevated. Women with severely impaired renal function before pregnancy are at risk for serious morbidity when their children are still young. Improvement might be made if all women were to receive specialized care and counselling before, throughout and after pregnancy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00400099
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
  • 2
    Electronic Resource
    Electronic Resource
    Pregnancies in women with diabetic nephropathy: long-term outcome for mother and child (1995)
    Springer
    Diabetologia 38 (1995), S. 227-235 
    Details
    ISSN: 1432-0428
    Keywords: Key words Diabetes mellitus ; nephropathy ; pregnancy.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In order to improve the basis upon which to advise women with diabetic nephropathy about pregnancy, we studied the effect of diabetic nephropathy on the course of pregnancy, perinatal outcome, infant development and long-term outcome of the mothers. All pregnancies of women with diabetic nephropathy (defined as proteinuria 〉 400 mg/day (n = 26), creatinine clearance 〈 80 ml/min and hypertension in the first trimester (n = 10) ) followed at our centre from 1982 to 1992 were identified (34 White class F and 2 White class T) and the women and their children re-examined in the spring 1993. From the first to the third trimester the percentage of women with proteinuria over 3 g/day increased from 14 to 53 % and those treated with antihypertensive medication from 53 to 97 %. There were no intrauterine or perinatal deaths, but one child died suddenly 4 weeks postpartum. Of 36 newborns (gestational week at birth 36(3), birth weight 2384(834) g) ), 11 were born before week 34 and 8 had respiratory distress syndrome. Renal function in the first trimester, diastolic blood pressure in the third trimester and an HbA1c above normal were predictive of gestational age at delivery and low birth weight (stepwise regression analysis). At follow-up of the children (n = 35, age 4.5 (0.4–10) years) the majority (n = 27) were normally developed but seven had psychomotor retardation (four of them major). One child had a severe motor retardation due to a congenital anomaly. At follow up, 21 of the 29 mothers had preserved renal function (creatinine 1.3 (0.8–4.3) mg/dl and 8 had developed end stage renal disease and required dialysis (2 of whom were White class T) within 3 (1–9) years postpartum. Of those, 4 women (3 White F and 1 White T) had died. Pregnancy did not seem to specifically accelerate the rate of decline of renal function. In women with diabetic nephropathy perinatal mortality can be prevented but perinatal and long-term infant morbidity remains elevated. Women with severely impaired renal function before pregnancy are at risk for serious morbidity when their children are still young. Improvement might be made if all women were to receive specialized care and counselling before, throughout and after pregnancy. [Diabetologia (1995) 38: 227–235].
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00400099
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
    Paper (German National Licenses)
    Fulltext
  • 3
    Electronic Resource
    Electronic Resource
    Pregnancy outcomes in mothers with pregestational diabetes: a population-based study in North Rhine (Germany) from 1988 to 1993 (1997)
    Springer
    European journal of pediatrics 156 (1997), S. 963-967 
    Details
    ISSN: 1432-1076
    Keywords: Key words Pregnancy ; Diabetes mellitus ; Perinatal mortality ; Prenatal care ; Prematurity
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The purpose of this study was to estimate the proportion of pregnancies with pregestational diabetes in Germany, to compare the outcome of these pregnancies to pregnancies in nondiabetic mothers and to identify risk factors for poor pregnancy outcomes in mothers with pregestational diabetes. Data of the “Perinatalerhebung Nordrhine” from 1988–1993 were analysed. The Perinatalerhebung is an ongoing quality assurance programme of prenatal and perinatal care in the region of North Rhine (South Western part of North Rhine-Westphalia). During the observation period a proportion of 93%–100% of the annual births in the region (n = ∼100000) were included in the study. Their data had been documented by the obstetricians in a standard multiple choice questionnaire. The outcome parameters perinatal mortality, macrosomia, prematurity, and malformations were analysed in relation to several defined explanatory variables. There were 2,402 births in mothers with pregestational diabetes (0.4% of all births). The proportions of poor pregnancy outcomes in women with pregestational diabetes were 2.8% for perinatal mortality, 27.6% for macrosomia, 21.1% for prematurity and 2.1% for malformations . The respective relative risks compared to the non diabetic mothers were 4.3 (95% CI 3.4–5.5) for perinatal mortality, 3.1 (95% CI 2.9–3.3) for macrosomia, 2.7 (95% CI 2.5–2.9) for prematurity and 1.7 (95% CI 1.3–2.3) for malformations . The main risk factor for perinatal mortality in children of diabetic mothers after adjustment for maternal smoking, ethnicity, parents' professional achievement, type of obstetric hospital, and maternal age was substandard use of prenatal care. Conclusions The prevalence of births from mothers with pregestational diabetes and their pregnancy outcomes were similar to those in other Western countries. The standard for non-diabetic mothers has not been reached yet. Further improvements may be achieved if all diabetic women are convinced to use the standard prenatal care facilities throughout pregnancy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004310050752
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
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