Abstract: FR-PO0970
Maternal and Neonatal Outcomes in Pregnant Women with Alport Syndrome (AS): A Multicenter Retrospective Cohort Study (ALPREG)
Session Information
- Women's Health and Kidney Diseases
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Women's Health and Kidney Diseases
- 2100 Women's Health and Kidney Diseases
Authors
- Allam, Krishna C., University of Minnesota Twin Cities, Minneapolis, Minnesota, 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
Group or Team Name
- ALPREG collaborators
Background
In AS, it is unknown whether defective COL 4 within placental collagen amplifies obstetric risk beyond that attributable to kidney disease alone, and whether the different inheritance patterns influence that risk.
Methods
We conducted a retrospective chart review of pregnant women, aged ≥18 years with confirmed AS, from 11 U.S. academic centers, to evaluate maternal and neonatal outcomes. Pregnancy-level outcomes were analyzed descriptively and compared among X-linked (XLAS), autosomal dominant (ADAS), and autosomal recessive (ARAS) subtypes using Fisher’s exact and Kruskal–Wallis tests.
Results
We identified 195 pregnancies in 108 women with AS, diagnosed by genetic testing in 79% and kidney biopsy in 35%. Median pre-pregnancy creatinine is 0.7 mg/dl and pre-pregnancy proteinuria is 0.64 g/g [IQR 0.14–1.45]. 19% has chronic hypertension. Key maternal complications included cesarean delivery (29%), preeclampsia (25%) and new onset/doubling of proteinuria (28%). Neonatal outcomes included preterm birth (16%), NICU admission (10%), and perinatal death (1.1%). The median birth weight was 3,182 g [IQR 2,820- 3,470]. No major differences in outcomes were observed among the different genetic subtypes; however, interpretation is limited by small subgroup sample sizes and missing data.
Conclusion
Despite largely preserved kidney function at conception, women with AS remained at risk for significant obstetric morbidity. Neonatal outcomes were generally favorable. Future analyses comparing AS with matched CKD controls may help define the independent role of collagen IV defects in placental dysfunction.
Acknowledgment
We would like to acknowledge the NKF for grant support and all the investigators from the contributing centers of the ALPREG study, listed here in alphabetical order: Alaa Jabri, Andrea Katah, Andrea Olverio, Diksha Deshmukh, Dana Rizk, Duvuru Geetha, Efren Chaves Morales, Gretchen Marrero Lozada, Hasan Hasan, Jaeine Lee, Kelcie Darpel, Lauren Blazek, Line Malha, Mallak Zatreh, Monica Reynolds, Nitya Srialluri, Reem Mustafa, Scott Lunos, Silvi Shah, Sreyochi Alam, and Yelena Drexler.