| Pregnancy in women with pre-existing lupus nephritis: predictors of fetal and maternal outcome. | |
| | |
MedLine Citation:
|
PMID: 18565977 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Only few data are available on pregnancy in patients with lupus nephritis (LN) diagnosed before conception. The aim of this study was to identify the risk factors for complicated pregnancy in women with pre-existing LN. METHODS: In a multicentre study, we collected data on 113 pregnancies occurring in 81 women with pre-existing biopsy-proven LN. Primary outcomes were fetal loss including perinatal death and renal flares during and 12 months after pregnancy. Univariate and logistic regression analyses were used to identify predictors of outcomes. RESULTS: Renal biopsy performed 7.2 +/- 4.9 years before pregnancy showed the following WHO classes: 6 patients in II, 8 in III, 48 in IV and 19 in V. At conception, most patients were in complete (49%) or partial (27%) remission. There were nine spontaneous abortions, one stillbirth and five neonatal deaths. Thirty-one deliveries were preterm. Birth weight was <2500 g in 34 newborns. During pregnancy or after delivery, there were 34 renal flares, most of which (20) were reversible. Three patients had a progressive decline of glomerular filtration rate (one on dialysis). At logistic regression analysis, the pregnancy outcome was predicted by hypocomplementaemia at conception (RR 19.02; 90% CI 4.58-78.96) and aspirin during pregnancy (RR 0.11; 90% CI 0.03-0.38). Renal flare was predicted by renal status (partial remission RR 3.0; 90% CI 1.23-7.34, nonremission RR 9.0; 90% CI 3.59-22.57). CONCLUSIONS: Pregnancy can be successful in most women with pre-existing LN, even for those with a severe renal involvement at onset. Renal flares during and after pregnancy are not uncommon and can be predicted by renal status assessed before pregnancy. Normocomplementaemia and low-dose aspirin therapy during pregnancy are independent predictors of a favourable fetal outcome. |
| | |
Authors:
|
Enrico Imbasciati; Angela Tincani; Gina Gregorini; Andrea Doria; Gabriella Moroni; Gianfranca Cabiddu; Daniele Marcelli |
Related Documents
:
|
11425837 - Use of time to event analysis to estimate the normal duration of human pregnancy. 18077317 - Obesity affects spontaneous pregnancy chances in subfertile, ovulatory women. 18716297 - Preeclampsia and the risk of end-stage renal disease. 9207827 - Higher rate of fetal acidemia after regional anesthesia for elective cesarean delivery. 536387 - Intercellular transfer of beta-glucuronidase in chimeric mice. 21763647 - Full-sibling embryos created by anonymous gamete donation in unrelated recipients. |
Publication Detail:
|
Type: Journal Article; Multicenter Study Date: 2008-06-18 |
Journal Detail:
|
Title: Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association Volume: 24 ISSN: 1460-2385 ISO Abbreviation: Nephrol. Dial. Transplant. Publication Date: 2009 Feb |
Date Detail:
|
Created Date: 2009-01-15 Completed Date: 2009-03-18 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8706402 Medline TA: Nephrol Dial Transplant Country: England |
Other Details:
|
Languages: eng Pagination: 519-25 Citation Subset: IM |
Affiliation:
|
Scuola di Specialità in Nefrologia, Università Milano Bicocca, Italy. enrico.imbasciati@fastwebnet.it |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Abortion, Spontaneous
/
etiology Adult Cohort Studies Female Humans Infant Mortality Infant, Newborn Lupus Nephritis / classification, complications*, drug therapy Pre-Eclampsia / etiology Pregnancy Pregnancy Complications / drug therapy, etiology* Pregnancy Outcome Prognosis Retrospective Studies Risk Factors Stillbirth |
| Comments/Corrections | |
Comment In:
|
Nephrol Dial Transplant. 2009 Feb;24(2):344-7
[PMID:
19037083
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Implantable cardiac defibrillator lead failure or myopotential oversensing? An approach to the diagn...
Next Document: Renal vasculitis in Japan and the UK--are there differences in epidemiology and clinical phenotype?