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Abstract: TH-PO735

Characterizing Fetal Outcomes in Women with Biopsy-Proven Primary Glomerular Disease

Session Information

Category: Women’s Health and Kidney Diseases

  • 2000 Women’s Health and Kidney Diseases

Authors

  • Berall, Laura E., University of Toronto, Toronto, Ontario, Canada
  • Arruda, Isabel, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
  • Yuan, Morgan, McMaster University, Hamilton, Ontario, Canada
  • Hui, Dini, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
  • Melamed, Nir, Sunnybrook Health Sciences Center, Toronto, Ontario, Canada
  • Hladunewich, Michelle A., University of Toronto, Toronto, Ontario, Canada
Background

It is well known that women with chronic kidney disease are at higher risk for worse maternal and fetal outcomes. However, the extent of these risks in women with biopsy proven primary glomerular disease has not been well described. This study aims to further characterize pregnancy outcomes in this population.

Methods

A database of women seen in a Pregnancy and Kidney Disease clinic at a tertiary care centre in Toronto, Canada was searched from January 2003 until July 2018 to identify women with biopsy-proven primary glomerular disease who had at least one pregnancy managed in this clinic. The primary study outcome was the live birth rate. Secondary study outcomes included birthweight, premature birth, spontaneous abortions and perinatal death (defined as stillbirth >20 weeks or neonatal death).

Results

218 pregnancies in 148 women (IgA nephropathy n=79, FSGS n=69, membranous nephropathy n=23, hereditary nephritis n=21, membranoproliferative glomerulonephritis n=15, minimal change disease n=11), were identified. Of these, 84.6% resulted in a live birth. 35.6% were born under 37 weeks gestational age (GA), with 29.7% of these at less than 32 weeks GA. 57 babies were born under the tenth percentile for their GA, 26.3% of these babies were less than the third percentile. There were 23 spontaneous abortions (SA) at less than 10weeks GA and 5 SA at 10-20weeks GA. In this cohort, 3.9% of pregnancies resulted in perinatal death.

Conclusion

Women with biopsy-proven glomerular disease are at high risk of adverse fetal outcomes. Further work needs to be done to characterize fetal outcomes by sub-category of glomerular disease, as well as to examine maternal outcomes.