Chronic Kidney Disease Ups Risk For Poor Pregnancy Outcomes


Disclosures: Dr. Alghonaim said he had no financial conflicts of interest.

SAN DIEGO — Although pregnant women with chronic kidney disease face an elevated risk of adverse maternal and fetal outcomes, most are able to deliver a surviving newborn, according to results from a multicenter study.

The current analysis is believed to be the second largest of its kind and supports earlier findings in the medical literature, Dr. Mohammed Alghonaim said in an interview during a poster session at the annual meeting of the American Society of Nephrology.

“These women need vigilant care,” said Dr. Alghonaim of the nephrology section in the department of medicine at King Saud University, Riyadh, Saudi Arabia. “If they've had a previous pregnancy, I would not advise them to get pregnant again if they have advanced-stage chronic kidney disease because of the potential for adverse maternal and fetal outcomes.”

In a study led by his associate at the university, Dr. Abdulkareem Alsuwaida, researchers at five tertiary hospitals in the Middle East reviewed 101 pregnancies in women (mean age, 32 years) with chronic kidney disease to estimate the rate of fetal, maternal, and neonatal complications.

The mean serum preconception creatinine concentration was 81.2 μmol/L, and the mean 24-hour urine proteinuria was 1.97 g/day. A total of 21 women (21%) had renal impairment, with a mean serum creatinine of 144 μmol/L.

In 10 pregnancies (10%), levels of serum creatinine rose more than 25% from preconception levels. Overall maternal and fetal complications included cesarean section (39%), preeclampsia (23%), preterm delivery (22%, with 4% delivered at less than 30 weeks' gestation), and intrauterine growth retardation (19%). Six infants (6%) were stillborn.

“Renal impairment was the most important predictor for both maternal and fetal complications,” Dr. Alghonaim said.

'Renal impairment was the most important predictor for both maternal and fetal complications.'


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