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肾衰竭孕妇母婴结局的相关性

Correlations between Maternal and Fetal Outcomes in Pregnant Women with Kidney Failure.

作者信息

Meca Daniela-Catalina, Varlas Valentin Nicolae, Mehedințu Claudia, Cîrstoiu Monica Mihaela

机构信息

Doctoral School of "Carol Davila" University of Medicine and Pharmacy, 4192910 Bucharest, Romania.

Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, 050451 Bucharest, Romania.

出版信息

J Clin Med. 2023 Jan 20;12(3):832. doi: 10.3390/jcm12030832.

Abstract

BACKGROUND

Kidney function impairment in pregnancy is challenging, with incidence and prognosis only partially known. Studies concerning maternal and fetal outcomes in pregnancies occurring in patients with renal injury and the therapeutic strategies for improving the prognosis of these patients are scarce due to the limited number of cases reported.

OBJECTIVES

We aimed to establish correlations between the main maternal and fetal outcomes in patients with severe CKD or AKI in pregnancy to improve the prognosis, referring to a control group of patients with mild kidney impairment.

METHODS

For this purpose, we conducted a retrospective study, at University Emergency Hospital in Bucharest, Romania, from January 2019 until December 2021, selecting 38 patients with AKI and 12 patients diagnosed with advanced CKD, compared to 42 patients displaying borderline values of serum creatinine (0.8-1 mg/dL), reflecting the presence of milder kidney impairment.

RESULTS

The probability of having a child that is premature and small for gestational age, with a lower Apgar score and more frequent neonatal intensive care unit admissions, delivered by cesarean section, is higher in patients with highly reduced kidney function.

CONCLUSION

Severe kidney function impairment is associated with a grim fetal prognosis and obstetrical complications.

摘要

背景

妊娠期肾功能损害具有挑战性,其发病率和预后仅部分为人所知。由于报告的病例数量有限,关于肾损伤患者妊娠的母婴结局以及改善这些患者预后的治疗策略的研究很少。

目的

我们旨在建立妊娠期重度慢性肾脏病(CKD)或急性肾损伤(AKI)患者主要母婴结局之间的相关性,以改善预后,并参照轻度肾功能损害患者的对照组。

方法

为此,我们于2019年1月至2021年12月在罗马尼亚布加勒斯特的大学急诊医院进行了一项回顾性研究,选择了38例AKI患者和12例诊断为晚期CKD的患者,并与42例血清肌酐值处于临界值(0.8 - 1mg/dL)的患者进行比较,这些临界值反映了较轻的肾功能损害。

结果

肾功能严重降低的患者剖宫产分娩出早产、小于胎龄、阿氏评分较低且新生儿重症监护病房入院频率更高的孩子的可能性更高。

结论

严重肾功能损害与严峻的胎儿预后和产科并发症相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/48dc/9917987/9a27d88349cb/jcm-12-00832-g001.jpg

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