Racial differences in the development of diabetic nephropathy after pregnancy

D. Skannal, B. Rosenn, M. Miodoimik, J. Khoury, G. Kopemik, T. Siddiqi

Research output: Contribution to journalArticlepeer-review


OBJECTIVE: To determine the association of race with the risk of developing diabetic nephropathy after pregnancy in women with insulindependent diabetes (IDDM). STUDY DESIGN: This study included 136 women with IDDM who enrolled in our Diabetes in Pregnancy program between 1978-1991, and who fulfilled the following inclusion criteria: ( 1 ) no nephropathy at onset of pregnancy, ('2.) delivery after 20 weeks gestation, (3) at least 3 years of follow-up after delivery. Nephropathy was defined as >500 tng proteinuria in 24 hours, in the absence of bacteruria, and excluding proteinuria related to pregnancy. Chi square and t-test were used for univariate comparisons, and a proportional hazards model was used for multivariate analysis. RESULTS: White (n = ll(i) and Black (n = 20) women were similar with respect to age, parity, and gravidity at enrollment, glycémie control during pregnancy, and median length of follow-up (9.0 and 9.6 years, respectively). Age at onset of diabetes was earlier (13.3 ±6.8 vs. 17.3 ±7.1 years), and average glycohemoglobin concentration during follow-up was better (3.7 i 2.5 vs. 5.4 ±3.4 SD above normal mean) in Whites. Nephropathy developed in 8 of the 116 White women (7%) and in 5 of the 20 Black women (25%; p = .01) after a median of 17.8 and 14.7 years of diabetes, respectively. Black women had a relative risk of 6.4 (CI = 2.1, 19.9) for developing nephropathy, even after adjusting for age at onset of diabetes, chronic hypertension at the time of pregnancy, and glycémie control. Parity was not a significant risk factor for development of diabetic nephropathy. CONCLUSIONS: Black race, but not pregnancy per se, is a significant risk factor for developing diabetic nephropathy after pregnancy. We speculate that genetic factors may contribute to this increased risk.

Original languageEnglish
Pages (from-to)S179
JournalActa Diabetologica Latina
Issue number1 PART II
StatePublished - 1997
Externally publishedYes


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