82 Can microalbuminuria predict preeclampsia in pregnant women with type 1 diabetes mellitus?

Abstract

Background Microalbuminuria is an early manifestation of diabetic microvascular kidney disease and studies evaluating its correlation with increased risk of preeclampsia (PE) are controversial. Predict the development of PE in these patients can direct preventive measures to reduce the maternal and fetal risks. Objetive To evaluate the predictive value of presence of microalbuminuria in pregnant women with type 1 diabetes mellitus for development of preeclampsia. Methods A prospective cohort study that evaluated pregnant women diagnosed with type 1 diabetes mellitus whose prenatal follow-up was performed at the Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo (HC-FMUSP) between the years 2013 and 2016. The presence of microalbuminuria before the twentieth week of pregnancy was evaluated. For analysis of the results at the end of the study, the patients were divided into two groups: without PE (I) and with PE (II). Statistical tests were performed with the help of IBM SPSS 16 software, through the calculation of Relative Risk, Sensitivity and Specificity, Positive Predictive Value and Negative Predictive Value, considering the significance level of p 0.05. The research is approved by the Ethics Committee for Research Project Analysis at HC-FMUSP. Results Of the 65 patients followed in the period, 20 (30.8%) developed preeclampsia. The presence of microalbuminuria was 13.3% (6/45) in group I and 33.3% (7/20) in group II, with correlation to the development of preeclampsia (RR = 2.03, CI = from 1.03 to 4.00, p = 0.0386). It is possible to predict PE with sensitivity = 35%, specificity = 86.7%, positive predictive value = 53.8%, negative predictive value = 75% and accuracy = 70.8%. There was no statistical difference between the groups in age, weight, Body Mass Index, disease duration and dosage of glycated hemoglobin in the first trimester. Conclusions In this cohort, the presence of microalbuminuria in pregnant women with type 1 diabetes mellitus correlates with increased incidence of preeclampsia, predicting their occurrence with high specificity and negative predictive value intermediate, therefore, is useful to point patients with lower risk.