Natalie L Davidson1, Penny Wolski2, Leonie K Callaway3, Helen L Barrett4, Narelle Fagermo5, Karin Lust5, Rebekah E Shakhovskoy6. 1. School of Medicine, University of Queensland, Brisbane, Queensland, Australia; Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia. 2. Department of Obstetric Medicine/Endocrinology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia. 3. School of Medicine, University of Queensland, Brisbane, Queensland, Australia. 4. Department of Internal Medicine and Maternity Services, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia. 5. Department of Obstetric Medicine, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia. 6. Department of Internal Medicine, Nambour General Hospital, Brisbane, Queensland, Australia.
Abstract
BACKGROUND: There is a paucity of Australian data regarding renal disease in pregnancy. We undertook a retrospective cohort study at a tertiary institution to examine the impact of renal disease on pregnancy outcomes and the effect of pregnancy on disease progression. METHODS: A total of 55 pregnancies of patients with renal disease admitted from 2003 to 2010 to the Royal Brisbane and Women's Hospital were analysed. Pre-conception variables, fetal/delivery and maternal outcomes were analysed in this group and in a control group of women with normal kidney function pre-pregnancy. RESULTS: Of the 55 pregnancies, 71% experienced pre-term delivery, 38% had intra-uterine growth restriction and 62% required caesarean section. Of all, 60% of neonates required neonatal intensive care unit (NICU) admission and six perinatal deaths occurred. Of all, 67% of women suffered preeclampsia, 47% anaemia and 3 patients required dialysis in pregnancy. Postpartum deterioration of renal function occurred in patients with pre-conception chronic kidney disease stage 3-5. CONCLUSIONS: Chronic kidney disease of all stages is a risk factor for adverse pregnancy outcomes. In a tertiary institution however, there is a high rate of successful pregnancy (84%).
BACKGROUND: There is a paucity of Australian data regarding renal disease in pregnancy. We undertook a retrospective cohort study at a tertiary institution to examine the impact of renal disease on pregnancy outcomes and the effect of pregnancy on disease progression. METHODS: A total of 55 pregnancies of patients with renal disease admitted from 2003 to 2010 to the Royal Brisbane and Women's Hospital were analysed. Pre-conception variables, fetal/delivery and maternal outcomes were analysed in this group and in a control group of women with normal kidney function pre-pregnancy. RESULTS: Of the 55 pregnancies, 71% experienced pre-term delivery, 38% had intra-uterine growth restriction and 62% required caesarean section. Of all, 60% of neonates required neonatal intensive care unit (NICU) admission and six perinatal deaths occurred. Of all, 67% of women suffered preeclampsia, 47% anaemia and 3 patients required dialysis in pregnancy. Postpartum deterioration of renal function occurred in patients with pre-conception chronic kidney disease stage 3-5. CONCLUSIONS:Chronic kidney disease of all stages is a risk factor for adverse pregnancy outcomes. In a tertiary institution however, there is a high rate of successful pregnancy (84%).
Authors: Andrew Smyth; Guilherme H M Oliveira; Brian D Lahr; Kent R Bailey; Suzanne M Norby; Vesna D Garovic Journal: Clin J Am Soc Nephrol Date: 2010-08-05 Impact factor: 8.237
Authors: Ziv Harel; Alison L Park; Eric McArthur; Michelle Hladunewich; Jade S Dirk; Ron Wald; Amit X Garg; Joel G Ray Journal: CMAJ Date: 2020-07-27 Impact factor: 8.262