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Jang, Choi, Nam, Kwon, Jo, Kim, and Shin: Factors influencing on perinatal outcomes in pregnancy with IgA nephropathy
Original Article
Journal of the Korean Ophthalmological Society

Journal of the Korean Ophthalmological Society 2010; 53(9): 787-794.

Published online: 22 September 2010

DOI: https://doi.org/10.0000/kjog.2010.53.8.787

Factors influencing on perinatal outcomes in pregnancy with IgA nephropathy

Dong Gyu Jang, MD, Yun Jin Choi, MD, Sun Young Nam, MD, Ji Young Kwon, MD, Yun Sung Jo, MD, Yeon Hee Kim, MD, Jong Chul Shin, MD

Department of Obstetrics and Gynecology, The Catholic University of Korea School of Medicine, Seoul, Korea.

Address reprint requests to Jong Chul Shin, MD. Department of Obstetrics and Gynecology, The Catholic University of Korea School of Medicine, Seoul, Korea. jcshin@catholic.ac.kr

Received 11 May 2010       Accepted 4 August 2010

Copyright © 2010 Korean Society of Obstetrics and Gynecology

Abstract

Objective

The aim of this study is to evaluate factors influencing on perinatal outcomes of pregnancy with IgA nephropathy and the effect of pregnancy on the prognosis of IgA nephropathy.

Methods

We retrospectively reviewed clinical and laboratory findings of 28 pregnancies in 25 pregnant women with biopsy-proven IgA nephropathy at six hospitals of Catholic Medical Center throughout the period of January 1999 to December 2009. They are divided into two groups by presence or absence of perinatal complications such as preeclampsia and preterm labor and then compared. The prognosis of IgA nephropathy was determined by serum creatinine level and diagnosis of end stage renal disease (ESRD) until 3 years after delivery. Fisher exact test and Mann-Witney U test were used for statistical analysis.

Results

The factors that related perinatal complications included high blood pressure (P=0.019), low glomerular filtration rate (less than 50 mL/min) (P=0.029), and high creatinine level (more than 2.0 mg/dL) (P=0.005). Especially, hypertension and high creatinine level (more than 2.0 mg/dL) increased risk of not only preterm birth (P=0.017, P=0.026, respectively) but also preeclampsia (P=0.008, P=0.001, respectively). The factors that increased risk of ESRD within 2 years after delivery included high creatinine level (more than 2.0 mg/dL) (P=0.018) and preeclampsia (P=0.018).

Conclusions

Our results indicate that hypertension and poor renal function could be predictors of poor perinatal outcomes, and when pregnancies with IgA nephropathy are complicated by preeclampsia or high creatinine level (more than 2.0 mg/dL), the prognosis of IgA nephropathy might be poor.

Keywords: IGA, Kidney failure, Pre-Eclampsia, Perinatal Outcomes

Figures and Tables

Table 1
Patient characteristics of IgA nephropathy in pregnancy
kjog-53-789-i001

Values are expressed as mean±SD or number (%).

BP: blood pressure, HBP: high blood pressure, GFR: glomerular filtration rate, Cr: creatinine.

*P<0.05.

Table 2
Univariate analysis of possible risk factors of perinatal complications in IgA nephropathy
kjog-53-789-i002

Values are expressed as mean±SD or number (%).

HBP: high blood pressure, GFR: glomerular filtration rate, Cr: creatinine.

*P<0.05.

Table 3
Univariate analysis of possible risk factors of preeclampsia in IgA nephropathy
kjog-53-790-i003

Values are expressed as mean±SD or number (%).

HBP: high blood pressure, GFR: glomerular filtration rate, Cr: creatinine.

*P<0.05.

Table 4
Univariate analysis of possible risk factors of preterm birth in IgA nephropathy
kjog-53-790-i004

Values are expressed as mean±SD or number (%).

HBP: high blood pressure, GFR: glomerular filtration rate, Cr: creatinine.

*P<0.05.

Table 5
Univariate analysis of possible risk factors of ESRD 2 years after delivery
kjog-53-791-i005

Values are expressed as mean±SD or number (%) .

ESRD: end stage renal disease, HBP: high blood pressure, GFR: glomerular filtration rate, Cr: creatinine.

*P<0.05.

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