Document Detail


Multiple pregnancies in CKD patients: an explosive mix.
MedLine Citation:
PMID:  23124785     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVES: CKD and multiple pregnancies bear important risks for pregnancy outcomes. The aim of the study was to define the risk for adverse pregnancy-related outcomes in multiple pregnancies in CKD patients in comparison with a control group of "low-risk" multiple pregnancies.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The study was performed in the Maternal Hospital of the University of Turin, Italy. Of 314 pregnancies referred in CKD (2000-2011), 20 were multiple (15 twin deliveries). Control groups consisted of 379 low-risk multiple pregnancies (314 twin deliveries) and 19 (15 twin deliveries) cases with hypertension-collagen diseases. Baseline data and outcomes were compared by univariate and logistic regression analyses.
RESULTS: The prevalence of multiple pregnancies was relatively high in the CKD population (6.4%); all referred cases were in early CKD stages (I-II); both creatinine (0.68 to 0.79 mg/dl; P=0.010) and proteinuria (0.81 to 3.42 g/d; P=0.041) significantly increased from referral to delivery. No significant difference in demographic data at baseline was found between cases and low-risk controls. CKD was associated with higher risk of adverse pregnancy outcomes versus low-risk twin pregnancies. Statistical significance was reached for preterm delivery (<34 weeks: 60% vs 26.4%; P=0.005; <32 weeks: 53.3% vs 12.7%; P<0.001), small for gestational age babies (28.6% vs 8.1%; P<0.001), need for Neonatal Intensive Care Unit (60% vs 12.7%; P<0.001), weight discordance between twins (40% vs 17.8%; P=0.032), and neonatal and perinatal mortality (6.6% vs 0.8%; P=0.032).
CONCLUSION: This study suggests that maternal-fetal risks are increased in multiple pregnancies in the early CKD stages.
Authors:
Giorgina Barbara Piccoli; Silvana Arduino; Rossella Attini; Silvia Parisi; Federica Fassio; Marlisa Biolcati; Arianna Pagano; Carlotta Bossotti; Elena Vasario; Valentina Borgarello; Germana Daidola; Martina Ferraresi; Pietro Gaglioti; Tullia Todros
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Publication Detail:
Type:  Journal Article     Date:  2012-11-02
Journal Detail:
Title:  Clinical journal of the American Society of Nephrology : CJASN     Volume:  8     ISSN:  1555-905X     ISO Abbreviation:  Clin J Am Soc Nephrol     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-01-08     Completed Date:  2013-06-13     Revised Date:  2014-01-10    
Medline Journal Info:
Nlm Unique ID:  101271570     Medline TA:  Clin J Am Soc Nephrol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  41-50     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Female
Humans
Hypertension, Pregnancy-Induced / epidemiology
Italy / epidemiology
Logistic Models
Multivariate Analysis
Pre-Eclampsia / epidemiology
Pregnancy
Pregnancy Complications / epidemiology*
Pregnancy Outcome / epidemiology*
Pregnancy, Multiple / statistics & numerical data*
Pregnancy, Twin / statistics & numerical data*
Premature Birth / epidemiology
Prevalence
Renal Insufficiency, Chronic / epidemiology*
Risk Factors
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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