Pg. Whittaker et T. Lind, THE INTRAVASCULAR MASS OF ALBUMIN DURING HUMAN-PREGNANCY - A SERIAL STUDY IN NORMAL AND DIABETIC WOMEN, British journal of obstetrics and gynaecology, 100(6), 1993, pp. 587-592
Objective To quantify the changes in serum albumin during human pregna
ncy. Design Longitudinal prospective study. Setting Before conception
and antenatal clinic. Subjects Sixty-nine normal women and 23 women wi
th Type 1 diabetes. Interventions Administration of Evans' blue dye an
d collection of serum samples. Main outcome measures Albumin concentra
tion, plasma volume and intravascular mass of albumin Results In norma
l subjects serum albumin concentration showed a significant decrease o
f 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 ch
ange of 22%. Plasma volume first increased significantly by 190 (95% C
I 105 to 275) ml between 7 and 12 weeks, with a further increase of 10
03 (95% CI 871 to 1135) ml between 12 and 36 weeks of pregnancy, a cha
nge of 53%. The intravascular mass of albumin showed no change between
non-pregnant, 7 and 12 week values but there was a significant rise o
f 19.5 (95% CI 15.1 to 23.9) g between 12 and 28 weeks of gestation, a
n overall increase of 19%. Diabetic subjects showed similar changes. C
onclusions Rather than simply reflecting plasma volume dilution, the c
hanges in serum albumin imply alterations in albumin metabolism during
pregnancy.