Risk Factors for Pregnancy Outcomes in Patients With IgA Nephropathy: A Matched Cohort Study

Liu, Youxia; Ma, Xinxin; Lv, Jicheng; Shi, Sufang; Liu, Lijun; Chen, Yuqing; Zhang, Hong

doi:10.1053/j.ajkd.2014.06.021

Cited by 37 publications

(36 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…On the other hand, proteinuria was previously demonstrated to be significantly associated with the deterioration of postnatal maternal outcomes (25). Youxia et al reported that proteinuria during pregnancy is a predictor of adverse pregnancy outcomes (26). However, only patients with >1 g/day proteinuria (N=10) exhibited complications such as HT (N=6, 60%) and low birth weight infants (N=3, 30%), regardless of the eGFR value.…”

Section: Discussionmentioning

confidence: 99%

Effect of Pregnancy and Delivery on the Renal Function and the Prognosis of Patients with Chronic Kidney Disease Stage 3 Caused by Immunoglobulin A Nephropathy

et al. 2015

View full text Add to dashboard Cite

Objective Immunoglobulin A nephropathy (IgAN) exhibits a peak onset that coincides with the reproductive age. Therefore, many young women with IgAN may become pregnant. However, the outcome of pregnancy in women with renal diseases remains controversial, and the characteristics and outcome of pregnancy in IgAN patients must be further evaluated. Methods A prospective follow-up study of 64 pregnant women with IgAN was performed by analyzing the laboratory data and prognosis. To clarify the influence of renal insufficiency, we compared these patients according to the chronic kidney disease (CKD) stage with special attention to CKD stage 3 [N=16 in total, N= 9 for estimated glomerular filtration rate (eGFR) ! 45 mL/min, N=7 for <45 mL/min]. Results We found that pregnancy and delivery did not produce any significant changes in the renal function for patients with CKD stage 3 (! 45 mL/min) at five years after delivery, although proteinuria was elevated at 30 weeks of pregnancy and at three months after delivery. However, only for patients with CKD stage 3 (<45 mL/min) was there a significant deterioration in the eGFR at five years after delivery. Additionally, the data of pregnant women with CKD stage 3 were compared with those of 22 nonpregnant women with similar clinical and demographic characteristics. Conclusion Pregnant patients with IgAN (CKD stage 3, eGFR ! 45 mL/min) did not exhibit any significant reduction in the renal function at five years after delivery as compared with the baseline, which was similar to the findings in nonpregnant patients. Thus, while pregnancy with CKD stage 3 (eGFR ! 45 mL/min) was not a risk factor, patients with CKD stage 3 (eGFR <45 mL/min) showed a worsened renal function five years after delivery.

show abstract

Section: Discussionmentioning

confidence: 99%

Effect of Pregnancy and Delivery on the Renal Function and the Prognosis of Patients with Chronic Kidney Disease Stage 3 Caused by Immunoglobulin A Nephropathy

et al. 2015

View full text Add to dashboard Cite

show abstract

“…7 Liu et al showed a similar association between proteinuria and adverse pregnancy outcomes in their cohort with IgA nephropathy. 8 Steroid therapy is the mainstay of treatment. Steroids were most commonly chosen to treat the glomerular lesions.…”

Section: Discussionmentioning

confidence: 99%

Maternal and perinatal outcome in a pregnancy with nephrotic syndrome

Mishra

Agarwal

Lamba

et al. 2017

Int J Reprod Contracept Obstet Gynecol

View full text Add to dashboard Cite

The influence of pregnancy on the subsequent course of pre-existing nephrotic syndrome is controversial as also the effect of membranous glomerulonephritis on maternal and perinatal outcome. We describe a case of successful pregnancy outcome in Hepatitis B reactive patient with pre-existing nephrotic syndrome (renal biopsy proven case of Membrano-proliferative Glomerulonephritis). She had regular nephrology consultation and her renal disease was well compensated. After sonographic confirmation of live intrauterine pregnancy at 9th gestational week, patient was given methylprednisolone (5mg once daily). Antihypertensive drugs were also given. At 35 weeks of gestation, patient went in labour and cesarean section was performed in view of previous caesarean section. Feto-maternal outcome was good. The intrapartum and postpartum period was uneventful. Renal functions were well preserved. A vigourous healthy 1.93 kg baby was discharged with mother in a stable condition after receiving hepatitis B immunoglobulin.

show abstract

“…Although pregnancy did not affect renal disease progression in this study, a second much smaller group studied with impaired renal function (n510 with baseline serum creatinine levels .1.2 mg/dl, averaging 1.6560.39 mg/dl) showed hastened progression, suggesting an imminent need for more data in women with IgA at more advanced stages of CKD. Finally, the most recently published study noted an association between proteinuria and adverse pregnancy outcomes (13). Time-averaged proteinuria, the arithmetic average of proteinuria during pregnancy and follow-up, was inversely associated with infant birth weight (correlation coefficient 5 20.61; P,0.001) and also associated with adverse pregnancy outcomes, including severe preeclampsia and intrauterine death (13).…”

Section: Systematic Review Of Primary Glomerular Diseasesmentioning

confidence: 99%

“…The most commonly reported GN was IgA nephropathy, with 12 studies including 10-136 patients (one study included two IgA cohorts) (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13). The proportion of women with hypertension at baseline was reported in eight studies and ranged from 9% to 40%.…”

Section: Systematic Review Of Primary Glomerular Diseasesmentioning

confidence: 99%

“…Finally, the most recently published study noted an association between proteinuria and adverse pregnancy outcomes (13). Time-averaged proteinuria, the arithmetic average of proteinuria during pregnancy and follow-up, was inversely associated with infant birth weight (correlation coefficient 5 20.61; P,0.001) and also associated with adverse pregnancy outcomes, including severe preeclampsia and intrauterine death (13). The strategy for managing worsening proteinuria during pregnancy in women with IgA is presently unclear.…”

Section: Systematic Review Of Primary Glomerular Diseasesmentioning

confidence: 99%

See 1 more Smart Citation

Pregnancy and Glomerular Disease

Blom

Odutayo

Bramham

et al. 2017

CJASN

View full text Add to dashboard Cite

During pregnancy, CKD increases both maternal and fetal risk. Adverse maternal outcomes include progression of underlying renal dysfunction, worsening of urine protein, and hypertension, whereas adverse fetal outcomes include fetal loss, intrauterine growth restriction, and preterm delivery. As such, pregnancy in young women with CKD is anxiety provoking for both the patient and the clinician providing care, and because the heterogeneous group of glomerular diseases often affects young women, this is an area of heightened concern. In this invited review, we discuss pregnancy outcomes in young women with glomerular diseases. We have performed a systematic review in attempt to better understand these outcomes among young women with primary GN, we review the studies of pregnancy outcomes in lupus nephritis, and finally, we provide a potential construct for management. Although it is safe to say that the vast majority of young women with glomerular disease will have a live birth, the counseling that we can provide with respect to individualized risk remains imprecise in primary GN because the existing literature is extremely dated, and all management principles are extrapolated primarily from studies in lupus nephritis and diabetes. As such, the study of pregnancy outcomes and management strategies in these rare diseases requires a renewed interest and a dedicated collaborative effort.

show abstract

Risk Factors for Pregnancy Outcomes in Patients With IgA Nephropathy: A Matched Cohort Study

Cited by 37 publications

References 16 publications

Effect of Pregnancy and Delivery on the Renal Function and the Prognosis of Patients with Chronic Kidney Disease Stage 3 Caused by Immunoglobulin A Nephropathy

Effect of Pregnancy and Delivery on the Renal Function and the Prognosis of Patients with Chronic Kidney Disease Stage 3 Caused by Immunoglobulin A Nephropathy

Maternal and perinatal outcome in a pregnancy with nephrotic syndrome

Pregnancy and Glomerular Disease

Contact Info

Product

Resources

About