Preeclampsia in diabetic pregnancies

A major risk factor for poor outcome of pregnancy is preeclampsia. This condition, which develops during pregnancy, is characterized by high blood pressure, headaches, excretion of protein in the urine, and accumulation of fluid in the lower limbs. If untreated, preeclampsia may develop into true eclampsia, which is characterized by coma and convulsive seizures occurring between the twentieth week of pregnancy and the end of the first week after birth. Studies show that the incidence of preeclampsia is greater in diabetic women than nondiabetic women, and that the incidence increases with the severity of diabetes. Diabetic pregnancies complicated by preeclampsia are associated with a poor outcome. Although the course and outcome of diabetic pregnancies have improved within the past 25 years, the effects of these changes on the incidence of preeclampsia in diabetic pregnancies have not been identified. The incidence of preeclampsia and the outcome of the mother and fetus were assessed in 334 diabetic pregnancies and 16,534 nondiabetic pregnancies. Preeclampsia developed in 33 of 334 diabetic pregnancies (9.9 percent) and 716 of 16,534 nondiabetic pregnancies (4.3 percent). The incidence of preeclampsia rose with increasing severity of diabetes, but remained at an incidence of 8.9 percent among diabetic pregnancies when women with kidney disease and chronic hypertension (high blood pressure) were excluded from the analysis. There were 60 newborn deaths per 1,000 births among preeclamptic diabetic patients and 3.3 newborn deaths per 1,000 births among diabetic patients without preeclampsia. The number of previous childbirths, age of the mother, and control of blood glucose levels did not differ between diabetics with and without preeclampsia. These findings show that preeclampsia occurs twice as frequently in diabetic pregnancies as in normal pregnancies. (Consumer Summary produced by Reliance Medical Information, Inc.)