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Kidney Week

Abstract: PO2238

Pregnancy Outcomes in C3 Glomerulopathy

Session Information

Category: Women’s Health and Kidney Diseases

  • 2000 Women’s Health and Kidney Diseases

Authors

  • Fergus, Lauren O., University of Iowa Molecular Otolaryngology and Renal Research Laboratories, Iowa City, Iowa, United States
  • Hall, Monica D., University of Iowa Molecular Otolaryngology and Renal Research Laboratories, Iowa City, Iowa, United States
  • Zhang, Yuzhou, University of Iowa Molecular Otolaryngology and Renal Research Laboratories, Iowa City, Iowa, United States
  • Smith, Richard J., University of Iowa Molecular Otolaryngology and Renal Research Laboratories, Iowa City, Iowa, United States
  • Nester, Carla Marie, University of Iowa Molecular Otolaryngology and Renal Research Laboratories, Iowa City, Iowa, United States
Background

C3 Glomerulopathy (C3G) is a glomerular disease characterized by underlying dysregulation of the alternative complement pathway. Most patients approach ESKD within ten years of diagnosis. Recurrence in renal transplants is high. Little is known of the role of pregnancy in the natural history of C3G or whether a coincident diagnosis affects comorbidities or maternal-fetal outcomes.

Methods

Female subjects in the University of Iowa’s C3G Natural History Study who met consensus biopsy criteria (n=76) and had at least one pregnancy (n=17) were included in the cohort. Clinical and lab data, including genetic and/or acquired drivers of disease studies were assessed. Standard peri-pregnancy outcomes were considered.

Results

44 pregnancies and 34 deliveries were identified. Non-live birth pregnancy outcomes included eight miscarriages, one ectopic pregnancy and one elective abortion. The presumed driver of disease was known for eight patients; gene variants of unknown significance (n=3), nephritic factors (n=4), and a monoclonal protein (n=1). Six patients presented first C3G symptoms during pregnancy. Preeclampsia developed in 11. Six infants were premature. Five were born with low birthweight. One infant suffered a stroke. One infant presented with AKI. [Maternal nephritic factor was identified in neonatal sera.]

Conclusion

We provide a summary of maternal-fetal outcomes in C3G mothers. Our data supports an increased risk of preeclampsia in C3G mothers as compared to healthy mothers. There was no excess risk of miscarriage, cesarean section, ectopic pregnancy, prematurity, or low birth weight. This data indicates a relatively higher risk of preeclampsia and lower risk of cesarean section compared to women with IgA Nephropathy. A similar risk of miscarriage, prematurity, and low birth weight as other glomerular diseases was evident. Our data supports a reasonable maternal-fetal risk profile for C3G patients.

Figure 1- Peri-Pregnancy Outcomes in C3G Mothers
 # of Pregnancies# of Live BirthsAverage Age at ConceptionFirst C3G Symptoms Before PregnancyFirst C3G Symptoms During PregnancyFirst C3G Symptoms After Pregnancy
n=443426665
 n=Sample %Healthy %
p valueIgA Nephropathy %p value
# of Preeclamptic Pregnancies1132.4%
4.0%
<.0001
9.0%<.0001
# of Premature Infants617.6%
9.8%
0.062
14.2%0.290
# of Low Birth Weight Infants514.7%
8.0%0.075
13.1%0.391
# of C-Sections514.7%
17.0%0.640
49.1%<.0001
# of Miscarriages818.2%
15.0%0.276
15%0.350