Korean J Obstet Gynecol.  2010 Sep;53(9):787-794. 10.5468/kjog.2010.53.9.787.

Factors influencing on perinatal outcomes in pregnancy with IgA nephropathy

• Jang DG
• Choi YJ
• Nam SY
• Kwon JY
• Jo YS
• Kim YH
• Shin JC

• KMID: 2077996
• DOI: http://doi.org/10.5468/kjog.2010.53.9.787

Abstract

OBJECTIVE
The aim of this study is to evaluate factors influencing on perinatal outcomes of pregnancy with IgA nephropathy and the effect of pregnancy on the prognosis of IgA nephropathy.
METHODS
We retrospectively reviewed clinical and laboratory findings of 28 pregnancies in 25 pregnant women with biopsy-proven IgA nephropathy at six hospitals of Catholic Medical Center throughout the period of January 1999 to December 2009. They are divided into two groups by presence or absence of perinatal complications such as preeclampsia and preterm labor and then compared. The prognosis of IgA nephropathy was determined by serum creatinine level and diagnosis of end stage renal disease (ESRD) until 3 years after delivery. Fisher exact test and Mann-Witney U test were used for statistical analysis.
RESULTS
The factors that related perinatal complications included high blood pressure (P=0.019), low glomerular filtration rate (less than 50 mL/min) (P=0.029), and high creatinine level (more than 2.0 mg/dL) (P=0.005). Especially, hypertension and high creatinine level (more than 2.0 mg/dL) increased risk of not only preterm birth (P=0.017, P=0.026, respectively) but also preeclampsia (P=0.008, P=0.001, respectively). The factors that increased risk of ESRD within 2 years after delivery included high creatinine level (more than 2.0 mg/dL) (P=0.018) and preeclampsia (P=0.018).
CONCLUSION
Our results indicate that hypertension and poor renal function could be predictors of poor perinatal outcomes, and when pregnancies with IgA nephropathy are complicated by preeclampsia or high creatinine level (more than 2.0 mg/dL), the prognosis of IgA nephropathy might be poor.

Keyword

IGA; Kidney failure; Pre-Eclampsia; Perinatal Outcomes

MeSH Terms

Creatinine
Female
Glomerular Filtration Rate
Glomerulonephritis, IGA
Humans
Hypertension
Immunoglobulin A
Kidney Failure, Chronic
Obstetric Labor, Premature
Pre-Eclampsia
Pregnancy
Pregnant Women
Premature Birth
Prognosis
Renal Insufficiency
Retrospective Studies
Creatinine
Immunoglobulin A

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