Diabetic Nephropathy and Pregnancy

Semin Nephrol. 2017 Jul;37(4):362-369. doi: 10.1016/j.semnephrol.2017.05.008.

Abstract

Women with diabetic nephropathy have challenging pregnancies, with pregnancy outcomes far worse than expected for the stage of chronic kidney disease. The underlying mechanisms that cause the adverse events remain poorly understood, but it is a widely held belief that substantial endothelial injury in these women likely contributes. Maternal hypertension, preeclampsia, and cesarean section rates are high, and offspring are often preterm and of low birth weight, with additional neonatal complications associated with glycemic control. This review will present the current evidence for maternal and fetal outcomes of women with diabetic nephropathy and describe prepregnancy, antenatal, and peripartum optimization strategies.

Keywords: Diabetes; nephropathy; preeclampsia; pregnancy.

Publication types

  • Review

MeSH terms

  • Blood Glucose / metabolism
  • Diabetic Nephropathies / complications*
  • Diabetic Nephropathies / physiopathology
  • Disease Progression
  • Female
  • Fetal Macrosomia / etiology
  • Glycated Hemoglobin / metabolism
  • Humans
  • Hypertension / drug therapy
  • Hypertension / etiology
  • Pre-Eclampsia / etiology
  • Preconception Care*
  • Pregnancy
  • Pregnancy in Diabetics / blood*
  • Pregnancy in Diabetics / drug therapy
  • Pregnancy in Diabetics / physiopathology
  • Prenatal Care*
  • Proteinuria / etiology
  • Stillbirth

Substances

  • Blood Glucose
  • Glycated Hemoglobin A
  • hemoglobin A1c protein, human