The intravascular mass of albumin during human pregnancy: a serial study in normal and diabetic women.

British journal of obstetrics and gynaecology

PubMedID: 8334096

Whittaker PG, Lind T. The intravascular mass of albumin during human pregnancy: a serial study in normal and diabetic women. Br J Obstet Gynaecol. 1993;100(6):587-92.
OBJECTIVE
To quantify the changes in serum albumin during human pregnancy.

DESIGN
Longitudinal prospective study.

SETTING
Before conception and antenatal clinic.

SUBJECTS
Sixty-nine normal women and 23 women with Type 1 diabetes.

INTERVENTIONS
Administration of Evans' blue dye and collection of serum samples.

MAIN OUTCOME MEASURES
Albumin concentration, plasma volume and intravascular mass of albumin.

RESULTS
In normal subjects serum albumin concentration showed a significant decrease of 1.9 (95% CI 1.0 to 2.9) g/l by 7 weeks gestation with a further 8.2 (95% CI 7.5 to 8.9) g/l decrease by 36 weeks gestation, an overall change of 22%. Plasma volume first increased significantly by 190 (95% CI 105 to 275) ml between 7 and 12 weeks, with a further increase of 1003 (95% CI 871 to 1135) ml between 12 and 36 weeks of pregnancy, a change of 53%. The intravascular mass of albumin showed no change between non-pregnant, 7 and 12 week values but there was a significant rise of 19.5 (95% CI 15.1 to 23.9) g between 12 and 28 weeks of gestation, an overall increase of 19%. Diabetic subjects showed similar changes.

CONCLUSIONS
Rather than simply reflecting plasma volume dilution, the changes in serum albumin imply alterations in albumin metabolism during pregnancy.