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. 2021 Oct;34(5):1591-1598.
doi: 10.1007/s40620-021-00979-2. Epub 2021 Mar 8.

Pregnancy outcomes in women with immunoglobulin A nephropathy: a nationwide population-based cohort study

Simon Jarrick  1   2 , Sigrid Lundberg  3   4 , Olof Stephansson  5   6 , Adina Symreng  5 , Matteo Bottai  7 , Jonas Höijer  7 , Jonas F Ludvigsson  8   9   10   11
Affiliations

Pregnancy outcomes in women with immunoglobulin A nephropathy: a nationwide population-based cohort study

Simon Jarrick et al. J Nephrol. 2021 Oct.

Abstract

Background: Immunoglobulin A nephropathy (IgAN) incidence peaks in childbearing age. Data on pregnancy outcomes in women with IgAN are limited.

Methods: We performed a register-based cohort study in a nationwide cohort of women with biopsy-verified IgAN in Sweden, comparing 327 pregnancies in 208 women with biopsy-verified IgAN and 1060 pregnancies in a matched reference population of 622 women without IgAN, with secondary comparisons with sisters to IgAN women. Adverse pregnancy outcomes, identified by way of the Swedish Medical Birth Register, were compared through multivariable logistic regression and presented as adjusted odds ratios (aORs). Main outcome was preterm birth (< 37 weeks). Secondary outcomes were preeclampsia, small for gestational age (SGA), low 5-min Apgar score (< 7), fetal or infant loss, cesarean section, and gestational diabetes.

Results: We found that IgAN was associated with an increased risk of preterm birth (13.1% vs 5.6%; aOR = 2.69; 95% confidence interval [CI] = 1.52-4.77), preeclampsia (13.8% vs 4.2%; aOR = 4.29; 95%CI = 2.42-7.62), SGA birth (16.0% vs 11.1%; aOR = 1.84; 95%CI = 1.17-2.88), and cesarean section (23.9% vs 16.2%; aOR = 1.74, 95%CI = 1.14-2.65). Absolute risks were low for intrauterine (0.6%) or neonatal (0%) death and for low 5-min Apgar score (1.5%), and did not differ from the reference population. Sibling comparisons suggested increased risks of preterm birth, preeclampsia, and SGA in IgAN, but not of cesarean section.

Conclusion: We conclude that although most women with IgAN will have a favorable pregnancy outcome, they are at higher risk of preterm birth, preeclampsia and SGA. Intensified supervision during pregnancy is warranted.

Keywords: Epidemiology; Glomerulonephritis; IgA nephropathy; Pregnancy; Prognosis.

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Conflict of interest statement

All authors have completed the Unified Competing Interest form (available on request from the corresponding author) and declare: no support from any organization for the submitted work; no financial relationships with any organizations that might have an interest in the submitted work in the previous three years; and no other relationships or activities that could appear to have influenced the submitted work.

Figures

Fig. 1
Fig. 1
Flow chart showing patient inclusion and exclusion. W   women, p pregnancies, c children
See this image and copyright information in PMC

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