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KMID : 0358420100530090787
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Korean Journal of Obstetrics and Gynecology
2010 Volume.53 No. 9 p.787 ~ p.794
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Factors influencing on perinatal outcomes in pregnancy with IgA nephropathy
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Jang Dong-Gyu
Shin Jong-Chul
Kwon Ji-Young
Jo Youn-Sung
Nam Sun-Young
Kim Yeon-Hee
Choi Youn-Jin
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Abstract
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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).
Conclusion: 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.
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KEYWORD
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IGA, Kidney failure, Pre-Eclampsia, Perinatal Outcomes
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