Grooters, Femke (2020) PREGNANCY IN PATIENTS WITH CHRONIC KIDNEY DISEASE. thesis, Medicine.
Full text available on request.Abstract
Background Women with chronic kidney disease (CKD) and women with a kidney transplant have higher risks of adverse outcomes during pregnancy. Therefore, in the past, these women were discouraged for getting pregnant. Nowadays it is more common for women with CKD to become pregnant with more comprehensive care. However, relatively little is known about the management during these high-risk pregnancies. Method This retrospective study evaluates the patient population and pregnancy outcomes of women with preexisting CKD who got pregnant at the University Medical Center Groningen (UMCG). Data is collected from electronic patient records in the UMCG. Descriptive data is used to describe the study population. Chi-square tests, Wilcoxon Rank test and logistic regression were used to compare differences between groups and paired data. Results In total 158 pregnancies were included from 98 women from 1995 till 2019. In 30 pregnancies the woman had a kidney transplant. The most common kidney diseases were kidney cysts (20.9%), IgA nephropathy (12.7%) and vasculitis/systemic disease (10.1%). A significant increase was found in CKD stage after pregnancy and stage of albuminuria, compared to before pregnancy (p = 0.000 and p = 0.002). In 58.9% of the pregnancies maternal complications occurred, most commonly hypertension (24.7%) and preeclampsia (19.6%). Fetal growth restriction occurred in 11.2% of the pregnancies and fetal death in 2.1%. Cesarean section was performed in 26,6%. Furthermore, prematurity occurred in 33.3%, low birth weight in 36.4%, 28.6% needed care in the neonatal intensive care unit and in 1.4% neonatal death occurred. Higher stages of CKD or albuminuria were associated with more adverse pregnancy outcomes. Of the adverse outcomes, only prematurity rates were higher in women with a history of kidney transplant(s) (p = 0.033) compared to women without a kidney transplant. No significant differences were found in adverse outcomes between pregnancies before and after 2010. Conclusion In conclusion, our study population demonstrates relatively high rates of adverse pregnancy outcomes. Pregnancy is a risk for deterioration of kidney function in these women and higher CKD stages before pregnancy are associated with more adverse pregnancy outcomes.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | dr. de Jong, M.F.C. and drs. Groenewout, M. |
| Faculty: | Medical Sciences |
| Date Deposited: | 02 Oct 2023 11:41 |
| Last Modified: | 02 Oct 2023 11:41 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3697 |
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