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Multiple pregnancies in CKD patients: an explosive mix.
Giorgina Barbara Piccoli1, Silvana Arduino, Rossella Attini
1Clinical and Biological Sciences, University of Torino at San Luigi, Turin, Italy. gbpiccoli@yahoo.it
Clinical Journal of the American Society of Nephrology : CJASN
|November 6, 2012
Summary
Multiple pregnancies in women with chronic kidney disease (CKD) significantly increase risks for adverse outcomes, including preterm birth and neonatal mortality, compared to low-risk pregnancies.
Area of Science:
- Obstetrics and Gynecology
- Nephrology
- Neonatology
Background:
- Chronic kidney disease (CKD) and multiple pregnancies are known risk factors for adverse pregnancy outcomes.
- The study investigates the specific risks associated with multiple pregnancies in women with early-stage CKD.
Purpose of the Study:
- To determine the risk of adverse pregnancy-related outcomes in multiple pregnancies among CKD patients.
- To compare these risks against a control group of low-risk multiple pregnancies.
Main Methods:
- Retrospective analysis of 314 pregnancies in CKD patients (2000-2011) at the Maternal Hospital of the University of Turin.
- Comparison of 20 multiple pregnancies in CKD patients with 379 low-risk multiple pregnancies.
- Statistical analysis using univariate and logistic regression.
Main Results:
- CKD patients had a higher prevalence of multiple pregnancies (6.4%) and showed significant increases in creatinine and proteinuria during pregnancy.
- Significantly higher rates of preterm delivery (<32 weeks: 53.3% vs 12.7%), small for gestational age babies (28.6% vs 8.1%), and NICU admission (60% vs 12.7%) were observed in the CKD group.
- Increased risks for twin weight discordance (40% vs 17.8%) and neonatal/perinatal mortality (6.6% vs 0.8%) were also noted in CKD pregnancies.
Conclusions:
- Multiple pregnancies in women with early-stage CKD (stages I-II) are associated with substantially increased maternal-fetal risks.
- These findings highlight the need for close monitoring and specialized care for pregnant women with CKD and multiple gestations.
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