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Maternal Medicine Posters
Is pre-eclampsia really increased in women with type 1 diabetes?
  1. MJA Maresh1,
  2. VA Holmes3,
  3. CC Patterson3,
  4. DWM Pearson4,
  5. JD Walker5,
  6. IS Young3,
  7. DR McCance2
  1. 1St Mary's Hospital for Women, Manchester, United Kingdom
  2. 2Royal Victoria Hospital, Belfast, United Kingdom
  3. 3University of Belfast, Belfast, United Kingdom
  4. 4Aberdeen Royal Infirmary, Aberdeen, United Kingdom
  5. 5St John's Hospital at Howden, Livingston, United Kingdom

Abstract

Pregnancy with type 1 diabetes is considered to have a high incidence of pre-eclampsia (PET), but these women often have hypertension or proteinuria at <20 weeks gestation confusing the diagnosis.

The DAPIT study randomised 762 women with type 1 diabetes to vitamin C and E supplementation, to investigate if this reduced the incidence of PET. As no significant effect was found both groups were combined allowing analysis of hypertensive disorders in a large cohort.

Before pregnancy, previous hypertension was noted in 25% of women who developed PET, 13% of women who developed gestational hypertension (GHT) and 10% who had neither (p <0.001).

By 20 weeks 32% of women had hypertension, proteinuria or both and 29% were subsequently classified as having PET in contrast to only 12% who had no problem <20 weeks (p <0.0001). However, of those who were classified as having PET, 56% had evidence of hypertensive or renal impairment <20 weeks compared to 24% who had no subsequent hypertensive problem (p <0.0001).

While liver enzymes and serum urate were significantly elevated in the PET group the results were similar whether or not there was a problem <20 weeks. However thrombocytopenia occurred more in the PET group who only had a problem >20 weeks. Birthweight <5th and <90th centile was significantly greater in the PET group, but significantly more in those with a problem<20 weeks.

In conclusion not all diabetic women classified as having PET appear to have the condition but further markers are required to differentiate.

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