Xingji Lian1,2,3, Li Fan1,2,3, Xin Ning1,2,3, Cong Wang1,2,3, Yi Lin1,2,3, Wenfang Chen4, Wei Chen1,2,3, Xueqing Yu1,2,3. 1. Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China. 2. NHC Key Laboratory of Nephrology (Sun Yat-sen University), Guangzhou, China. 3. Guangdong Provincial Key Laboratory of Nephrology, Guangzhou, China. 4. Department of Pathology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Abstract
Background: Gestation complications have a recurrence risk and could predispose to each other in the next pregnancy. We aimed to evaluate the relationship between a history of adverse pregnancy and maternal-fetal outcomes in subsequent pregnancy in patients with Immunoglobulin A nephropathy (IgAN). Methods: A retrospective cohort study from a Chinese single center was conducted. Pregnant women with biopsy-proven primary IgAN and aged ≥18 years were enrolled and divided into the 2 groups by a history of adverse pregnancy. The primary outcome was adverse pregnancy outcome, which included maternal-fetal outcomes. Logistical regression model was used to evaluate the association of a history of adverse pregnancy with subsequent adverse maternal and fetal outcomes. Results: Ninety-one women with 100 pregnancies were included, of which 54 (54%) pregnancies had a history of adverse pregnancy. IgAN patients with adverse pregnancy history had more composite maternal outcomes (70.4% vs. 45.7%, p = 0.012), while there was no difference in the composite adverse fetal outcomes between the 2 groups (55.6% vs. 45.7%). IgAN patients with a history of adverse pregnancy were associated with an increased risk of subsequent adverse maternal outcomes (adjusted odds ratio [OR], 2.64; 95% CI, 1.07-6.47). Similar results were shown in those with baseline serum albumin <3.5 g/dL, 24 h proteinuria ≥1 g/day, and a history of hypertension. There was no association between a history of adverse pregnancy and subsequent adverse fetal outcomes in IgAN patients (adjusted OR, 1.56; 95% CI, 0.63-3.87). Conclusion: A history of adverse pregnancy was associated with an increased risk of subsequent adverse maternal outcomes, but not for adverse fetal outcomes in IgAN patients.
Background: Gestation complications have a recurrence risk and could predispose to each other in the next pregnancy. We aimed to evaluate the relationship between a history of adverse pregnancy and maternal-fetal outcomes in subsequent pregnancy in patients with Immunoglobulin A nephropathy (IgAN). Methods: A retrospective cohort study from a Chinese single center was conducted. Pregnant women with biopsy-proven primary IgAN and aged ≥18 years were enrolled and divided into the 2 groups by a history of adverse pregnancy. The primary outcome was adverse pregnancy outcome, which included maternal-fetal outcomes. Logistical regression model was used to evaluate the association of a history of adverse pregnancy with subsequent adverse maternal and fetal outcomes. Results: Ninety-one women with 100 pregnancies were included, of which 54 (54%) pregnancies had a history of adverse pregnancy. IgAN patients with adverse pregnancy history had more composite maternal outcomes (70.4% vs. 45.7%, p = 0.012), while there was no difference in the composite adverse fetal outcomes between the 2 groups (55.6% vs. 45.7%). IgAN patients with a history of adverse pregnancy were associated with an increased risk of subsequent adverse maternal outcomes (adjusted odds ratio [OR], 2.64; 95% CI, 1.07-6.47). Similar results were shown in those with baseline serum albumin <3.5 g/dL, 24 h proteinuria ≥1 g/day, and a history of hypertension. There was no association between a history of adverse pregnancy and subsequent adverse fetal outcomes in IgAN patients (adjusted OR, 1.56; 95% CI, 0.63-3.87). Conclusion: A history of adverse pregnancy was associated with an increased risk of subsequent adverse maternal outcomes, but not for adverse fetal outcomes in IgAN patients.
Authors: Hitoshi Suzuki; Krzysztof Kiryluk; Jan Novak; Zina Moldoveanu; Andrew B Herr; Matthew B Renfrow; Robert J Wyatt; Francesco Scolari; Jiri Mestecky; Ali G Gharavi; Bruce A Julian Journal: J Am Soc Nephrol Date: 2011-09-23 Impact factor: 10.121
Authors: Hannah Blencowe; Simon Cousens; Mikkel Z Oestergaard; Doris Chou; Ann-Beth Moller; Rajesh Narwal; Alma Adler; Claudia Vera Garcia; Sarah Rohde; Lale Say; Joy E Lawn Journal: Lancet Date: 2012-06-09 Impact factor: 79.321
Authors: Sehoon Park; Kyung Don Yoo; Joong Shin Park; Joon-Seok Hong; Seungdon Baek; Su-Kil Park; Ho Jun Chin; Ki Young Na; Yunhee Choi; Dong Ki Kim; Kook-Hwan Oh; Kwon Wook Joo; Yon Su Kim; Hajeong Lee Journal: Nephrol Dial Transplant Date: 2018-03-01 Impact factor: 5.992
Authors: U Vivian Ukah; Dane A De Silva; Beth Payne; Laura A Magee; Jennifer A Hutcheon; Helen Brown; J Mark Ansermino; Tang Lee; Peter von Dadelszen Journal: Pregnancy Hypertens Date: 2017-11-21 Impact factor: 2.899
Authors: Cande V Ananth; Morgan R Peltier; Martin R Chavez; Russell S Kirby; Darios Getahun; Anthony M Vintzileos Journal: Obstet Gynecol Date: 2007-07 Impact factor: 7.661