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. 2013 Jan;8(1):41-50.
doi: 10.2215/CJN.02550312. Epub 2012 Nov 2.

Multiple pregnancies in CKD patients: an explosive mix

Giorgina Barbara Piccoli  1 , Silvana Arduino, Rossella Attini, Silvia Parisi, Federica Fassio, Marlisa Biolcati, Arianna Pagano, Carlotta Bossotti, Elena Vasario, Valentina Borgarello, Germana Daidola, Martina Ferraresi, Pietro Gaglioti, Tullia Todros
Affiliations

Multiple pregnancies in CKD patients: an explosive mix

Giorgina Barbara Piccoli et al. Clin J Am Soc Nephrol. 2013 Jan.

Abstract

Background and objectives: CKD and multiple pregnancies bear important risks for pregnancy outcomes. The aim of the study was to define the risk for adverse pregnancy-related outcomes in multiple pregnancies in CKD patients in comparison with a control group of "low-risk" multiple pregnancies.

Design, setting, participants, & measurements: The study was performed in the Maternal Hospital of the University of Turin, Italy. Of 314 pregnancies referred in CKD (2000-2011), 20 were multiple (15 twin deliveries). Control groups consisted of 379 low-risk multiple pregnancies (314 twin deliveries) and 19 (15 twin deliveries) cases with hypertension-collagen diseases. Baseline data and outcomes were compared by univariate and logistic regression analyses.

Results: The prevalence of multiple pregnancies was relatively high in the CKD population (6.4%); all referred cases were in early CKD stages (I-II); both creatinine (0.68 to 0.79 mg/dl; P=0.010) and proteinuria (0.81 to 3.42 g/d; P=0.041) significantly increased from referral to delivery. No significant difference in demographic data at baseline was found between cases and low-risk controls. CKD was associated with higher risk of adverse pregnancy outcomes versus low-risk twin pregnancies. Statistical significance was reached for preterm delivery (<34 weeks: 60% vs 26.4%; P=0.005; <32 weeks: 53.3% vs 12.7%; P<0.001), small for gestational age babies (28.6% vs 8.1%; P<0.001), need for Neonatal Intensive Care Unit (60% vs 12.7%; P<0.001), weight discordance between twins (40% vs 17.8%; P=0.032), and neonatal and perinatal mortality (6.6% vs 0.8%; P=0.032).

Conclusion: This study suggests that maternal-fetal risks are increased in multiple pregnancies in the early CKD stages.

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Figures

Figure 1.
Figure 1.
Flowchart of the study population.
See this image and copyright information in PMC

References

    1. MacLean AB, Sharp F, Briggs JD, MacPherson SG: Successful triplet pregnancy following renal transplantation. Scott Med J 25: 320–322, 1980 - PubMed
    1. Boner G, Bott-Kanner G, Schweitzer A, Danon YL, Rosenfeld JB: Successful multiple pregnancy in renal transplant recipient. Int J Gynaecol Obstet 19: 251–254, 1981 - PubMed
    1. Pavlović NB, Kostić S, Cvetković A, Stefanović V: Successful twin pregnancy in a renal transplant patient. Przegl Lek 42: 403–405, 1985 - PubMed
    1. Grunebaum AN, Minkoff H: Twin gestation and perinatal follow-up in a woman with severe chronic renal failure managed without dialysis. A case report. J Reprod Med 32: 463–465, 1987 - PubMed
    1. Burrows DA, O’Neil TJ, Sorrells TL: Successful twin pregnancy after renal transplant maintained on cyclosporine A immunosuppression. Obstet Gynecol 72: 459–461, 1988 - PubMed