Ehrich J H, Loirat C, Davison J M, Rizzoni G, Wittkop B, Selwood N H, Mallick N P
Charite Children's Hospital, Humboldt University, Berlin, Germany.
Nephrol Dial Transplant. 1996 Jul;11(7):1314-7.
Between 1967 and 1990, 820 successful pregnancies in 718 women on renal replacement therapy (RRT) were reported to the EDTA Registry.
This study analyses data on repeated successful pregnancies in 102 of these women, of whom 99 had two and three had three pregnancies.
Primary renal diseases were mainly glomerulonephritis (41%), pyelonephritis (32%), and congenital malformations such as cystic diseases and hypoplasia or dysplasia (3%). Mean age at start of RRT was 21 years +/-5 SD. Ninety-four per cent of the women had the same transplant during the first and second pregnancies; 85% of these were alive with their first graft and 9% with a second graft; 4% were retransplanted after the first pregnancy and 2% were back on dialysis during the second pregnancy. Of the mothers with two successful pregnancies, two-thirds had a serum creatinine below 121 micromol/l after the first or after the second pregnancy. Six mothers lost their first graft after the first pregnancy. None of the mothers had died after delivery of the second or third baby. Several features of the first and the second pregnancy in these mothers were quite similar. Mean gestational age was 36 weeks+/-3SD during first and second pregnancy. Mean birth weight (height) of the first child was 2490 g+/-660 SD (48 cm+/-4 SD) and 2587 g+/-639 SD (50 cm+/-3 SD) of the second child (NS). Neonatal mortality was 4% after the first and second delivery; congenital abnormalities were found in five and three children respectively.
Fourteen per cent of mothers who had a successful pregnancy on RRT subsequently had a second baby. Repeated pregnancies should not adversely affect graft function and/or fetal development provided that graft function was well preserved at the time of conception.
1967年至1990年间，EDTA登记处报告了718名接受肾脏替代治疗（RRT）的女性成功妊娠820次。
本研究分析了其中102名女性反复成功妊娠的数据，其中99名有两次妊娠，3名有三次妊娠。
原发性肾脏疾病主要为肾小球肾炎（41%）、肾盂肾炎（32%）以及先天性畸形，如囊性疾病和发育不全或发育异常（3%）。开始接受RRT时的平均年龄为21岁±5标准差。94%的女性在第一次和第二次妊娠期间接受了相同的移植；其中85%的人第一次移植的肾脏存活，9%的人第二次移植的肾脏存活；4%的人在第一次妊娠后再次移植，2%的人在第二次妊娠期间重新开始透析。在有两次成功妊娠的母亲中，三分之二的人在第一次或第二次妊娠后血清肌酐低于121微摩尔/升。6名母亲在第一次妊娠后失去了第一次移植的肾脏。没有母亲在分娩第二个或第三个婴儿后死亡。这些母亲第一次和第二次妊娠的几个特征非常相似。第一次和第二次妊娠期间的平均孕周为36周±3标准差。第一个孩子的平均出生体重（身高）为2490克±660标准差（48厘米±4标准差），第二个孩子为2587克±639标准差（50厘米±3标准差）（无显著性差异）。第一次和第二次分娩后的新生儿死亡率均为4%；分别在5名和3名儿童中发现先天性异常。
在接受RRT治疗期间成功妊娠的母亲中，14%随后又生育了第二个孩子。只要受孕时移植肾功能良好，反复妊娠不应对移植肾功能和/或胎儿发育产生不利影响。
