Pregnancy Outcomes And Risk Factors In 101 Patients With Chronic Kidney Disease

Objective To analyse the risk factors of adverse pregnancy outcomes in women with chronic kidney disease.Methods The analysis was retrospective,101 pre-pregnancy CKD female patients who achieved singleton pregnancy were collected in our unit from January 2010 to August 2018.350 pregnancies without CKD were collected as the control group.CKD patients were divided into normal renal function group(CKD 1 stage,n=84)and renal dysfunction group(CKD2-4 stage,n=17)according to the estimated golmerular filtration rate(e GFR).Fetal and maternal outcomes were analyzed between the CKD 1 stage and the control group,CKD 2-4 stage and CKD 1 stage.Results(1)The incidence of preterm,cesarean section are higher in normal renal function group than in the control group.Renal dysfunction group had higher incidence of preterm,early preterm,small for gestational age infant(SGA),neonatal intensive care unit(NICU),cesarean section than in the normal renal function group.(2)CKD2-4 stage is an independent risk factor for early preterm,NICU,and cesarean section.Baseline proteinuria ≥ 1.0g/24 h and baseline hypertension are independent risk factors for preterm,and age is an independent risk factor for cesarean section.(3)In renal dysfunction group,serum creatinine increased and e GFR decreased postpartum.There was no significant difference in serum creatinine and e GFR between pre-pregnancy and postpartum in patients with normal renal function.Postpartum median proteinuria in both CKD groups was significantly higher than that before pregnancy.Conclusion Compared with women without CKD,CKD patients have an increased risk of fetal and maternal adverse outcomes,and the incidence of adverse pregnancy outcomes increases with progression of renal function.