Document Detail


Ambulatory blood pressure as predictor of preeclampsia in diabetic pregnancies with respect to urinary albumin excretion rate and glycemic regulation.
MedLine Citation:
PMID:  11846705     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Twenty-four-hour ambulatory blood pressure was evaluated as a predictor of preeclampsia in women with insulin-dependent diabetes mellitus with respect to urinary albumin excretion rate and glycemic regulation. METHODS: One hundred and fifty-one women with insulin-dependent diabetes mellitus were consecutively recruited from the outpatient maternity ward for 24 hour ambulatory blood pressure measurement with a portable monitor (SpaceLab 90207). Blood pressure was measured three times during pregnancy and once after delivery. Evaluation was performed with receiver-operator-characteristics curves in primiparous women. Stratified analysis and multiple regression was applied with respect to urinary albumin excretion rate, HbA1c, age, duration of diabetes mellitus, uric acid, and BMI. RESULTS: The incidence of preeclampsia was significantly associated with increasing urinary albumin excretion rate, primiparity, and ambulatory blood pressure. Ambulatory blood pressure was associated with HbA1c throughout pregnancy adjusted for urinary albumin excretion rate. The ambulatory blood pressure was higher from first trimester throughout pregnancy in women developing preeclampsia compared to women who did not have preeclampsia. The best sensitivity and specificity for predicting preeclampsia in primiparous women were at cut-off values of systolic and diastolic day ambulatory blood pressure above 122 and 74 mmHg, respectively. The relative risk of preeclampsia was significantly higher when ambulatory blood pressure was above the cut-off values and increased further with higher urinary albumin excretion rate. CONCLUSIONS: The relationship between ambulatory blood pressure and preeclampsia is not confined to women with macroalbuminuria but is also present in women with normo- and microalbuminuria. Poor glycemic control and increased urinary albumin excretion rate is associated with preeclampsia when ambulatory blood pressure is above cut-off values of 122/74 mmHg (systole/diastole). Ambulatory blood pressure is a reliable measurement for prediction of preeclampsia in primiparous women with insulin-dependent diabetes mellitus.
Authors:
F F Lauszus; O W Rasmussen; T Lousen; T M Klebe; J G Klebe
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta obstetricia et gynecologica Scandinavica     Volume:  80     ISSN:  0001-6349     ISO Abbreviation:  Acta Obstet Gynecol Scand     Publication Date:  2001 Dec 
Date Detail:
Created Date:  2002-02-15     Completed Date:  2002-03-12     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370343     Medline TA:  Acta Obstet Gynecol Scand     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  1096-103     Citation Subset:  IM    
Affiliation:
Gynecological/Obstetrical Department Y, Skejby Hospital, Aarhus, Denmark. affl@ringamt.dk
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Albuminuria / urine*
Birth Weight
Blood Glucose / metabolism*
Blood Pressure / physiology*
Blood Pressure Monitoring, Ambulatory
Creatinine / urine
Diabetes Mellitus, Type 1 / blood,  physiopathology*,  urine
Female
Hemoglobin A, Glycosylated / metabolism
Humans
Infant, Newborn
Male
Pre-Eclampsia / blood,  diagnosis*,  urine
Pregnancy
Pregnancy in Diabetics / blood,  complications*,  urine
Prospective Studies
ROC Curve
Regression Analysis
Sensitivity and Specificity
Uric Acid / blood
Chemical
Reg. No./Substance:
0/Blood Glucose; 0/Hemoglobin A, Glycosylated; 60-27-5/Creatinine; 69-93-2/Uric Acid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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