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The combination of pregnancy and glomerular diseases is uncommon. Therefore, the frequency of adverse maternal and fetal outcomes is poorly known.
A restrospective study was performed on medical records of pregnant patients who were diagnosed with glomerular disease that was confirmed by renal biopsy. The study analized adverse outcomes for both mother and the fetus. Descriptive statistics were used for the analysis, with chi-square was used to compare outcomes between primary glomerulopathies (PGN) and secondary glomerulopathies (SGN). P-value < 0.05 was considered to be significant.
We analyzed 498 pregnancies in 484 patients with chronic kidney disease, identifying 136 cases (27.3%) with glomerulopathies and 362 cases (72.7%) with other etiologies. Fifty-one cases were identified with PGN (37.5%) and 85 cases with SGN (62.5%). Renal biopsy was performed in 63 patients (54.3%). The most frequent primary glomerulopathies were focal segmental glomerulosclerosis (64.7%), membranous nephropathy (15.7%), membranoproliferative glomerulonephritis (7.8%), IgA nephropathy 4 cases (7.8%), and thin basement membranes (4%). Among the secondary glomerulopathies, the most frequent were diabetic nephropathy (61.2%), lupus nephritis (37.7%) and postinfectious glomerulonephritis (1.1%). The percentage of live newborns was 97.8% in the PGN group and 97.4% in the SGN group (p=0.874). Preterm delivery was observed in 16 cases (34%) in the PGN group vs 57 cases (76%) in GNS (p=<0.001), as well as preeclampsia in 11 cases (22.9%) in the GNP group vs 43 cases (54.4%) in GNS (p=<0.001). Low birth weight was also observed in 18 cases (39.1%) in PGN vs 55 cases (75.3%) in SGN (p=<0.001). Finally, admission to NICU were observed in 10 cases (21.7%) vs 41 cases (54.7%) in GNS (p=<0.001).
No differences were observed between the PGN and SGN groups in cesarean section, abortion and neonatal death.
Preterm delivery, preeclampsia, low birth weight and admission to the NICU were more frequent in the secondary glomerulopathy group. No differences were observed in the other of the maternal and fetal outcomes.