IgA nephropathy and pregnancy

In the present study, we investigated the pregnancy course of 60 pregnant women with IgA nephropathy according to the grade of nephropathy. All the patients had undergone open renal biopsy at the Renal Metabolism Unit, Department of Internal Medicine, Tokai University Hospital, before pregnancy. The items analyzed were the serum biochemical data, the occurrence and severity of EPH-gestosis, the frequency of low birth weight infants, and the incidence of intrauterine growth retardation (IUGR). Analysis of the serum biochemical data revealed no statistically significant differences among the various grades. Investigating the occurrence and severity of EPH-gestosis revealed that the incidence was 0.0% in patients of grade I (n = 7), 56.1% for mild EPH-gestosis and 22.0% for severe EPH-gestosis in those of grade II (n = 41), 45.5% for mild EPH-gestosis and 18.2% for severe EPH-gestosis in those of grade III (n = 11), and 0.0% in those of grade IV (n = 1). These results showed statistically significant differences in the incidence of EPH-gestosis according to the grade. Analyzing the frequency of low birth weight infants (less than 2,500 g at birth) showed rates of 28.6% for grade I, 17.1% for grade II, 36.4% for grade III, and 100.0% for grade IV. No statistically significant differences were observed. The incidence of IUGR was 0.0% for grade I, 9.8% for grade II, 18.2% for grade III, and 0.0% for grade IV, indicating no statistically significant differences. Therefore, we concluded that in pregnancy complicated with IgA nephropathy, if the renal function before pregnancy was satisfactory, an uneventful course of pregnancy could be expected by careful control of the patients, although the incidence of EPH-gestosis was high.