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Kidney Week

Abstract: TH-PO1016

High Burden of Adverse Pregnancy Outcomes in Alport Syndrome: Insights from a US National Patient Survey

Session Information

Category: Women's Health and Kidney Diseases

  • 2200 Women's Health and Kidney Diseases

Authors

  • Allam, Krishna C, University of Minnesota Twin Cities, Minneapolis, Minnesota, United States
  • Nasr, Kristina Karim, Cleveland Clinic, Cleveland, Ohio, United States
  • Rheault, Michelle N., University of Minnesota Twin Cities, Minneapolis, Minnesota, United States
  • Nachman, Patrick H., University of Minnesota Twin Cities, Minneapolis, Minnesota, United States
  • Koubar, Sahar, University of Minnesota Twin Cities, Minneapolis, Minnesota, United States
Background

Chronic Kidney Disease (CKD) poses maternal and fetal risks to pregnant women, but data on the specific risks associated with individual kidney diseases remain limited. In Alport syndrome (AS), concerns about pregnancy outcomes arise not only from the underlying kidney dysfunction but also from the potential impact of defective type IV collagen causing abnormal placentation.

Methods

We conducted a national survey of women ≥18 years with confirmed AS, to assess their fertility, pregnancy complications, renal outcomes, and neonatal health. Participants were recruited from the ASTOR (Alport Syndrome Treatment and Outcomes Registry) and completed a CHERRIES-compliant online survey. Data were analyzed descriptively at the pregnancy level.

Results

58 out of 284 women answered the survey. The mean age at delivery was 29.1 years ±5.4 and 84.5% were white. 40% (18/45) reported at least one miscarriage, 20% reported a history of infertility and 23% reported undergoing assisted reproductive techniques. Of 111 pregnancies lasting >20 weeks, 92.2% (59/64) had X-linked AS, 19.8% were delivered by C-section, 7.2% had gestational hypertension and 30.6% reported preeclampsia. Postpartum patient-reported worsening of creatinine and proteinuria occurred in 39.3% and 29.8% respectively. Preterm delivery (<37weeks) occurred in 16.2%, low birth weight (<2500g) in 11.9% and neonatal ntensive care admission in 17.1%.

Conclusion

Patient-reported data suggest increased risks of infertility, pre-eclampsia, and preterm delivery in women with AS. These findings require validation through case-control studies using a matched pregnancy cohort, to better inform and guide AS-specific care.

Digital Object Identifier (DOI)