Indian journal of nephrology · 2024
Maternal, Fetal, and Kidney Outcomes of Viable Pregnancies in Women with Underlying Kidney Disease: Experience from a Single Tertiary Care Center in India.
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Johny Joseph, Mani Selvin Sundar Raj, Alam Rizwan, Jose Nisha, Lalwani Manish, Eapen Jeethu Joseph, Thomas Athul, John Elenjickal Elias, David Liji Sarah, Abraham Kavitha, Alexander Suceena, David Vinoi George, Benjamin Santosh Joseph, Varughese Santosh
Аннотация
BACKGROUND: There is a dearth of data from resource-limited settings on pregnancy outcomes in women with kidney disease. We investigated the maternal, fetal, and renal outcomes of pregnancies amongst women with kidney disease and compared these outcomes with normal pregnancy outcomes.
MATERIALS AND METHODS: This was a single-center retrospective observational study. The maternal, fetal, and renal outcomes of women with kidney dysfunction who delivered at the study center after at least 22 weeks of gestation (viable pregnancy) between January 2012 and December 2021 were analyzed. The study results were also compared with the outcomes of normal pregnancy.
RESULTS: Two hundred and one deliveries were included in the study, constituting 0.14% of all deliveries during the study period. Lupus nephritis (39.3%) and Immunoglobulin A nephropathy (11.4%) were the most common underlying kidney diseases. The mean (±SD) gestational age at delivery was 34.9 (±3.7) weeks. A higher cesarean section rates (45.3%) were observed in these high-risk pregnancies. Low birth weight was observed in 51.7% of all deliveries. Renal outcome regarding proteinuria and estimated glomerular filtration rate was excellent. Renal transplant patients had unfavorable outcomes. More than 45% of patients had term deliveries with normal birth weight.
CONCLUSION: Satisfactory maternal, fetal, and renal outcomes can be achieved with proper pre-pregnancy counseling and multidisciplinary care in women with kidney diseases, even in resource-limited settings.
MATERIALS AND METHODS: This was a single-center retrospective observational study. The maternal, fetal, and renal outcomes of women with kidney dysfunction who delivered at the study center after at least 22 weeks of gestation (viable pregnancy) between January 2012 and December 2021 were analyzed. The study results were also compared with the outcomes of normal pregnancy.
RESULTS: Two hundred and one deliveries were included in the study, constituting 0.14% of all deliveries during the study period. Lupus nephritis (39.3%) and Immunoglobulin A nephropathy (11.4%) were the most common underlying kidney diseases. The mean (±SD) gestational age at delivery was 34.9 (±3.7) weeks. A higher cesarean section rates (45.3%) were observed in these high-risk pregnancies. Low birth weight was observed in 51.7% of all deliveries. Renal outcome regarding proteinuria and estimated glomerular filtration rate was excellent. Renal transplant patients had unfavorable outcomes. More than 45% of patients had term deliveries with normal birth weight.
CONCLUSION: Satisfactory maternal, fetal, and renal outcomes can be achieved with proper pre-pregnancy counseling and multidisciplinary care in women with kidney diseases, even in resource-limited settings.