Korean J Nephrol.  2010 Mar;29(2):224-231.

Fetal and Maternal Outcomes of Pregnancy in Women with IgA Nephropathy

• Kim YJ
• Park SK
• Kim A
• Won HS
• Yang WS
• Park JS

Abstract

PURPOSE
To determine the effects of: 1) IgA nephropathy (IgAN) on fetal outcome; 2) gestation on maternal outcome; and 3) pregnancy on the long-term prognosis of IgAN.
METHODS
Ninety pregnancies in 75 women with biopsy-proven IgAN between 1989 and 2004 were evaluated retrospectively. The long-term prognosis of IgAN was determined by estimating glomerular filtration rate (GFR) 5 years after delivery and comparing the results from 75 matched non-pregnant patients with IgAN.
RESULTS
Multivariate analysis showed that baseline renal function was the only predictor of fetal outcome. Hypertension and impaired renal function before pregnancy were associated with poor maternal outcome during pregnancy, whereas histologic grade was related to the long-term prognosis of IgAN. Five years after delivery, GFR did not differ between pregnant (63.6+/-33.4 mL/min) and non-pregnant (63.2+/-32.5 mL/min) women with IgAN.
CONCLUSION
Impaired renal function appears an important prognostic factor for fetal outcome. Short- term maternal prognosis was dependent on pre-pregnancy clinical parameters associated with IgAN, whereas long-term prognosis was dependent on histopathologic parameters of IgAN itself. Pregnancy per se had no adverse effects on the natural history of IgAN.

Keyword

IgA nephropathy; Outcome; Pregnancy

MeSH Terms

Female
Glomerular Filtration Rate
Glomerulonephritis, IGA
Humans
Hypertension
Immunoglobulin A
Multivariate Analysis
Natural History
Pregnancy
Prognosis
Retrospective Studies
Immunoglobulin A