Renal disease in pregnancy: Fetal, neonatal and long-term outcomes

Haseler, Emily; Melhem, Nabil; Sinha, Manish D.

doi:10.1016/j.bpobgyn.2019.01.018

Cited by 17 publications

(8 citation statements)

References 104 publications

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“…There is growing evidence that even in the early stages of CKD (CKD1 and 2), the risk of adverse pregnancy outcomes is higher than in the general population [26]. In our cohort, the incidence of preterm delivery was roughly 3 times higher than in controls, even in the CKD1 group.…”

Section: Discussionmentioning

confidence: 47%

“…Pregnancy in women with GN is associated with a relatively high risk of adverse pregnancy outcomes, mainly preterm birth, with possible lifelong consequences for the offspring. The recent review on renal disease in pregnancy by Haseler et al [26] underlines the short-term risks for the neonate, including neurological, infectious, and respiratory complications. At the same time, it is emphasized that prematurity and hypotrophy are burdened with a higher risk of cardiovascular, renal, and metabolic disorders [26].…”

Section: Discussionmentioning

confidence: 99%

“…The recent review on renal disease in pregnancy by Haseler et al [26] underlines the short-term risks for the neonate, including neurological, infectious, and respiratory complications. At the same time, it is emphasized that prematurity and hypotrophy are burdened with a higher risk of cardiovascular, renal, and metabolic disorders [26]. In our study, the incidence of preterm delivery below 37 weeks in all GN patients was 41.7%, the frequency of hypotrophy below the 10th percentile was 12.5%, and there were no stillbirths or neonatal deaths.…”

Section: Discussionmentioning

confidence: 99%

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Neonatal and Maternal Outcomes among Women with Glomerulonephritis

et al. 2020

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Background: The outcomes of pregnancy in women with renal diseases remain controversial. The purpose of the study was to report fetal and maternal outcomes among women with glomerular disease in comparison with healthy pregnant women and a review of the current literature on this issue. Methods: Retrospective analysis included 72 pregnancies in 62 women with biopsy-proven glomerulonephritis (GN) (in 65.3% of cases, immunoglobulin A nephropathy was found). The control group consisted of 315 healthy pregnant women. We assessed fetal (prematurity, low birth weight, hypotrophy, fetal malformation, or intrauterine death) and maternal (gestational hypertension, preeclampsia, deterioration in kidney function, and maternal death) outcomes. Descriptive data analysis, Fisher's exact test, unpaired Student's t test, and ANOVA were performed. Results: Hypertension prevalence among the GN group and controls was 76.4 and 10.2%, respectively. Preeclampsia complicated 29.2% of pregnancies among women with GN and 2.9% of controls. In 8.3% of patients, at least a 50% decrease in GFR during pregnancy was observed. Preterm delivery prevalence in the GN group and controls was 74.7 and 12.7%, respectively. Hypotrophy was diagnosed in 12.5% of cases from the GN group and 5.4% of controls. The analysis showed that low estimated glomerular filtration rate, hypertension, and proteinuria were risk factors of adverse neonatal outcomes. Conclusion: Women with GN are a risk factor of adverse pregnancy outcomes. As pregnancy complications are more prevalent across all the CKD stages, even in patients with near-normal kidney function, they require specialized care. It might be advisable to screen pregnant women for the presence of CKD, as especially in the early stage, it is often asymptomatic. Both hypertension and proteinuria are risk factors for neonatal and maternal complications.

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Section: Discussionmentioning

confidence: 47%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Neonatal and Maternal Outcomes among Women with Glomerulonephritis

et al. 2020

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“…The WHO recommends breastfeeding for all babies until 6 months of age, even in patients on immunosuppressive therapy. Although studies found trace amount of immunosuppressives excreted into breast milk, the amount absorbed by infant is negligible and do not exert any clinical effect [130]. Hence, immunosuppressives deemed safe during pregnancy such as corticosteroid, AZA and CNIs can be safely taken during breastfeeding [114].…”

Section: After Pregnancymentioning

confidence: 99%

Lupus Nephritis: Current Updates

Adeeb¹,

Adnan²

2021

Lupus - Need to Know

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Lupus is a heterogenous multisystem autoimmune disease whereby nephritis is one of its most common cause of overall morbidity and mortality. Accurate, timely diagnosis and effective treatment in lupus nephritis (LN) remains a challenge to many clinicians including those who are directly involved in the daily care of these patients. Despite significant improvement in patients’ survival rate in recent years, in this era of precision medicine, there is pressing need to further improve our understanding and management of this disease. Our chapter would shed light on the key issues in LN including recent advances in our scientific understanding of its’ pathophysiology, major challenges and treatment strategies.

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“…29,33,40 There may be an increased risk of fetal malformation with moderate-severe CKD, but no association has been found with earlier-stage disease. 41 Maternal and fetal risks are increased with multiple pregnancies. 42 Certain conditions such as immunological renal disease, systemic lupus erythematosus and vesicoureteric reflux have been shown to have worse pregnancy outcomes compared with other types of kidney disorders; however, this has not been particularly noted with ADPKD.…”

Section: Ckd and Pregnancymentioning

confidence: 99%

<p>Management of Autosomal Dominant Polycystic Kidney Disease (ADPKD) During Pregnancy: Risks and Challenges</p>

McBride¹,

Wilkinson²,

Jesudason³

2020

IJWH

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Autosomal dominant polycystic kidney disease (ADPKD) affects up to 1 in 1000 people. The disease is characterized by the progressive development of cysts throughout the renal parenchyma due to inherited pathogenic variants in genes including PKD1 or PKD2 and eventually leads to gradual loss of renal function, along with manifestations in other organ systems such as hepatic cysts and intracranial aneurysms. ADPKD management has advanced considerably in recent years due to genetic testing availability, pre-implantation genetic diagnosis technology and new therapeutic agents. Renal disease in pregnancy is recognised as an important risk factor for adverse maternal and fetal outcome. Women with ADPKD and health professionals face multiple challenges in optimising outcomes during the pre-pregnancy, pregnancy and post-partum periods.

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Renal disease in pregnancy: Fetal, neonatal and long-term outcomes

Cited by 17 publications

References 104 publications

Neonatal and Maternal Outcomes among Women with Glomerulonephritis

Neonatal and Maternal Outcomes among Women with Glomerulonephritis

Lupus Nephritis: Current Updates

<p>Management of Autosomal Dominant Polycystic Kidney Disease (ADPKD) During Pregnancy: Risks and Challenges</p>

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