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妊娠前糖尿病女性的早期妊娠蛋白尿与先兆子痫发生率增加有关吗?

Is early-pregnancy proteinuria associated with an increased rate of preeclampsia in women with pregestational diabetes mellitus?

作者信息

How Helen Y, Sibai Baha, Lindheimer Marshall, Caritis Steve, Hauth John, Klebanoff Mark, Macpherson Cora, Van Dorsten Peter, Miodovnik Menachem, Landon Mark, Paul Richard, Meis Paul, Thurnau Gary, Dombrowski Mitchell, Roberts James

机构信息

National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units, Bethesda, MD, USA.

出版信息

Am J Obstet Gynecol. 2004 Mar;190(3):775-8. doi: 10.1016/j.ajog.2003.11.031.

Abstract

OBJECTIVE

The purpose of this study was to determine whether the rate of preeclampsia in pregnant diabetic women is increased in those women with early-pregnancy proteinuria of 190 to 499 mg/24 hours compared with women with proteinuria of <190 mg/24 hours.

STUDY DESIGN

Secondary analysis was performed with relevant data from 194 pregnant women with type 1 and type 2 diabetes mellitus whose condition required insulin and who were enrolled previously in a multicenter trial of low-dose aspirin for the prevention of preeclampsia. The women were assigned to 1 of 3 groups, based on the level of proteinuria at enrollment (13-26 weeks of gestation). Group 1 comprised women with <190 mg protein/24 hours (n=94); group 2 comprised women with 190 to 499 mg protein/24 hours (n=35); and group 3 comprised women with >/=500 mg protein/24 hours (n=65). The rate of preeclampsia, according to strict predefined criteria, was then determined.

RESULTS

The rate of preeclampsia was not increased statistically significantly in patients with early-pregnancy proteinuria of 190 to 499 mg/24 hours (7/35 women; 20%) when compared with women with proteinuria of <190 mg/24 hours (16/94 women; 17%).

CONCLUSION

We did not find an increased rate of preeclampsia in women with pregestational diabetes mellitus with early-pregnancy proteinuria of 190 to 499 mg/24 hours when compared with women with pregestational diabetes mellitus with proteinuria of <190 mg/24 hours.

摘要

目的

本研究旨在确定妊娠糖尿病女性中,妊娠早期蛋白尿为190至499mg/24小时的女性与蛋白尿<190mg/24小时的女性相比,子痫前期的发生率是否增加。

研究设计

对194例1型和2型糖尿病孕妇的相关数据进行二次分析,这些孕妇病情需要胰岛素治疗,且之前参加了一项预防子痫前期的低剂量阿司匹林多中心试验。根据入组时(妊娠13 - 26周)的蛋白尿水平,将这些女性分为3组。第1组包括蛋白尿<190mg/24小时的女性(n = 94);第2组包括蛋白尿为190至499mg/24小时的女性(n = 35);第3组包括蛋白尿≥500mg/24小时的女性(n = 65)。然后根据严格预定义的标准确定子痫前期的发生率。

结果

与蛋白尿<190mg/24小时的女性(16/94例女性;17%)相比,妊娠早期蛋白尿为190至499mg/24小时的患者(7/35例女性;20%)子痫前期发生率无统计学显著增加。

结论

与妊娠糖尿病且妊娠早期蛋白尿<190mg/24小时的女性相比,我们未发现妊娠糖尿病且妊娠早期蛋白尿为190至499mg/24小时的女性子痫前期发生率增加。

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