Strategies for reducing the frequency of preeclampsia in pregnancies with insulin-dependent diabetes mellitus

Chaur Dong Hsu, Hai Ying Tan, Shih Fen Hong, Nancy A. Nickless, Joshua A. Copel

Research output: Contribution to journalArticlepeer-review

24 Scopus citations

Abstract

The object of this study was whether improving glycemic control and maintaining normal glycosylated hemoglobin (HbA(1c)) through pregnancy can reduce the frequency of preeclampsia. One hundred and twenty-three compete medical records of pregnant insulin-dependent diabetics (IDDM) managed at Yale-New Haven Hospital from 1983 to 1993 were reviewed. Serial HbA(1c) measurements and the occurrence of preeclampsia were recorded. Based on the change of HbA(1c) values through the pregnancy, glycemic control was categorized into four groups: group 1, high to normal; group 2, high to high; group 3, normal to normal; group 4, normal to high. The association between HbA(1c) change and the incidence of preeclampsia was analyzed by chi-square test and Fisher's exact test. Among 123 IDDM pregnancies, 40 (32.5%) developed preeclampsia. High HbA(1c) levels at any time in IDDM pregnancies were associated with an increased incidence of preeclampsia (group 1 or 2 or 4 versus group 3). Reducing HbA(1c) by improving glycemic control both before and during pregnancy resulted in a significantly lower incidence of pre- eclampsia (group 3 versus groups 1+2+4, p<0.05). The best strategy for reducing the frequency of preeclampsia in IDDM pregnancies is by improving glycemic control before pregnancy.

Original languageEnglish (US)
Pages (from-to)265-268
Number of pages4
JournalAmerican Journal of Perinatology
Volume13
Issue number5
DOIs
StatePublished - Jul 1996
Externally publishedYes

Keywords

  • glycosylated hemoglobin
  • insulin-dependent diabetes mellitus
  • Preeclampsia

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

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