Analysis Of Pregnancy Outcome And Influencing Factors In Patients With Chronic Kidney Disease

Objective:To investigate the pregnancy outcome and influencing factors of patients with chronic kidney disease(CKD).Methods:A retrospective analysis method was used to select 312 patients who were hospitalized in the obstetrics department of Shengjing Hospital Affiliated to China Medical University from January 1,2015 to December 30,2018,and were divided into a case group and a control group.Case group: There is a clear history of CKD before pregnancy,or a clear kidney injury is found before 20 weeks of pregnancy,and persists.Follow-up is at least 6months after delivery.The kidney injury has not returned to normal,a total of 111 cases,according to eGFR divided into A Group: eGFR?60ml · min-1 ·(1.73 m2)-1,84people;Group B: eGFR <60ml · min-1 ·(1.73 m2)-1,27 people;Control group:randomly selected hospital age matching A total of 201 patients without CKD,hypertension,diabetes,heart disease,rheumatic immune disease and other basic diseases.The age,weight,blood pressure,urine routine,24-hour urine protein quantification,liver function,kidney function and other indicators of the two groups were compared and analyzed,as well as pregnancy comorbidities,fetal outcomes,and renal outcomes of patients.Results:Compared with the control group,the gestational age of the case group was significantly lower(P <0.01),urine protein quantitation,TG,BUN,and Scr were significantly increased(P <0.01),and Hb,ALB,and eGFR were significantly reduced(P values were<0.01,<0.05,<0.01),systolic and diastolic blood pressure were higher than the control group(P <0.05),the incidence of adverse pregnancy complications was significantly increased,of which the incidence of pregnancy-induced hypertension and severe preeclampsia were significantly increased(P <0.01),the incidence of induced labor,premature labor,stillbirth,intrauterine growth retardation was significantly increased(P<0.01);there was no worsening of renal function in the case group and control group after 6 months of follow-up,and renal function and protein in the case group There were significantly more patients with urine recovery than the control group(p <0.05).Further multiple regression analysis showed that systolic blood pressure had a clear effect on kidney recovery(p <0.05).Conclusions:1.Compared with normal pregnant women,the incidence of pregnancy comorbidities and adverse pregnancy outcomes in patients with chronic kidney disease increased significantly,and increased with the severity of renal impairment,suggesting that CKD patients should be closely followed up during pregnancy,timely detection and Intervene in pregnancy complications and adverse pregnancy outcomes to ensure the safety of mothers and infants.2.Compared with before pregnancy,pregnant women's kidney function decreased during pregnancy,and the incidence of moderate to severe urine protein increased,but after delivery,the decline in renal function and moderate to severe urine protein recovery can be restored.Compared with pre-pregnancy,postpartum renal function and urinary protein changes were small,but because of the small sample size in this study,the possibility of bias cannot be ruled out,and the sample size should be enlarged to better assess kidney outcomes.