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Pregnancy Outcome in Women with Chronic Kidney Disease: A Prospective Cohort Study

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Abstract

Objective

To evaluate pregnancy outcome in women with chronic kidney disease (CKD) or proteinuria in early pregnancy with concomitant risk for preeclampsia (PE).

Methods

Thirty-six women with CKD (Cr > 100 μmol/L at booking or Cr > 125 μmol/L prepregnancy or proteinuria ≥ 500 mg/24 hours at booking) and 30 women with proteinuria (≥2+) and known clinical risk for PE were enrolled at 14+0 to 21+6 weeks. Pregnancy outcomes were assessed.

Results

Women with mild CKD (prepregnancy Cr < 125 µmol/Cr > 100 µmol at booking; n = 22) had high rates of preeclampsia (40%), preterm delivery (<37weeks’ gestation; 54%), SGA infants (<10th adjusted centile; 64%)and perinatal death (5%). Women with moderate/severe CKD (prepregnancy creatinine > 125 µmol; n = 14) had poor perinatal outcomes: preterm delivery (86%) and perinatal death (14%). Women with proteinuria (≥2+) and concomitant risk of PE also had high rates of pre-eclampsia (60%), preterm delivery (40%), and SGA infants (27%).

Conclusions

Pregnancy complications for women with CKD remain high. Women with risk factors for PE with proteinuria (≥2+) at booking are also high-risk.

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Authors and Affiliations

  1. Maternal and Fetal Research Unit, Division of Reproduction and Endocrinology, King’s College London School of Biomedical and Health Sciences, London, UK

    Kate Bramham MRCP, Paul T. Seed MSc, Lucilla Poston PhD, FRCOG, Andrew H. Shennan PhD, FRCOG & Lucy C. Chappell PhD, MRCOG

  2. Biomedical Research Centre, Guy’s and St Thomas’ NHS Foundation Trust, London, UK

    Kate Bramham MRCP & Annette L. Briley MSc

  3. Maternal and Fetal Research Unit, King’s College London School of Medicine, St Thomas’ Hospital, Westminster Bridge Road, London, SE1 7EH, UK

    Kate Bramham MRCP

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  1. Kate Bramham MRCP
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  2. Annette L. Briley MSc
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  3. Paul T. Seed MSc
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  4. Lucilla Poston PhD, FRCOG
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  5. Andrew H. Shennan PhD, FRCOG
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  6. Lucy C. Chappell PhD, MRCOG
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Correspondence to Kate Bramham MRCP.

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Bramham, K., Briley, A.L., Seed, P.T. et al. Pregnancy Outcome in Women with Chronic Kidney Disease: A Prospective Cohort Study. Reprod. Sci. 18, 623–630 (2011). https://doi.org/10.1177/1933719110395403

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