| Fetal and Maternal Outcomes of Pregnancy in Women with IgA Nephropathy |
| Yoon Ji Kim, M.D.1, Su-Kil Park, M.D.1, Ahm Kim, M.D.2, Hye Sung Won, M.D.2, Won Seok Yang, M.D.1 and Jung Sik Park, M.D.1 |
Division of Nephrology, Department of Internal Medicine1 and Department of Obstetrics and Gynecology2
University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea |
| 원저 : Fetal and Maternal Outcomes of Pregnancy in Women with IgA Nephropathy |
| Yoon Ji Kim, M.D.1, Su-Kil Park, M.D.1, Ahm Kim, M.D.2, Hye Sung Won, M.D.2, Won Seok Yang, M.D.1 and Jung Sik Park, M.D.1 |
| Division of Nephrology, Department of Internal Medicine1 and Department of Obstetrics and Gynecology2, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea |
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| Abstract |
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Purpose : To determine the effects of: 1) IgA nephropathy (IgAN) on fetal outcome; 2) gestation on maternal outcome; and 3) pregnancy on the long-term prognosis of IgAN.
Methods : Ninety pregnancies in 75 women with biopsy-proven IgAN between 1989 and 2004 were evaluated retrospectively. The long-term prognosis of IgAN was determined by estimating glomerular filtration rate (GFR) 5 years after delivery and comparing the results from 75 matched non-pregnant patients with IgAN.
Results : Multivariate analysis showed that baseline renal function was the only predictor of fetal outcome. Hypertension and impaired renal function before pregnancy were associated with poor maternal outcome during pregnancy, whereas histologic grade was related to the long-term prognosis of IgAN. Five years after delivery, GFR did not differ between pregnant (63.6±33.4 mL/min) and non-pregnant (63.2±32.5 mL/min) women with IgAN.
Conclusion : Impaired renal function appears an important prognostic factor for fetal outcome. Shortterm maternal prognosis was dependent on pre-pregnancy clinical parameters associated with IgAN, whereas long-term prognosis was dependent on histopathologic parameters of IgAN itself. Pregnancy per se had no adverse effects on the natural history of IgAN. |
| Key Words:
IgA nephropathy, Outcome, Pregnancy |
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