阿尔波特综合征妇女的妊娠过程和结果

M. Aksenova, V. V. Dlin
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摘要

CKD 患者妊娠与母体和胎儿风险相关。评估 Alport 综合征妇女的妊娠过程和结果。单中心回顾性研究纳入了 88 名经基因确诊的女性患者。受孕时的临床数据、妊娠过程、分娩(早产<37孕周;早期早产<34孕周)、胎儿特征(宫内胎儿生长受限:身高<2孕龄z分数;小于孕龄:体重<2孕龄z分数)等信息均来自病历和对妇女的横断面调查。结果获得了 117 例足月妊娠(26 例中有 2 例,3 例中有 3 例)的信息。1/3的妇女(q=0.37)有妊娠并发症:蛋白尿(q=0.23)、高血压(q=0.1)、流产威胁(q=0.21)。1/4的妇女出现早产和早期早产(q=0.26),其中 3%的病例为早期早产。宫内胎儿生长受限和胎龄偏小的新生儿分别占 9% 和 11%;7% 的婴儿需要入住新生儿重症监护室。蛋白尿是子痫前期(OR=42.35 3±1.1;p<0.001)、早产(OR=11.8±0.5;p<0.001)、宫内胎儿生长受限(OR=12.2±0.7;p<0.001)、胎龄小(OR=7.2±0.6;p<0.001)的风险因素。患有阿尔波特综合征且肾功能正常的妇女发生子痫前期和胎儿生长受限的风险与普通人群相当。但这种疾病应被视为早产的潜在风险因素。蛋白尿与阿尔波特综合征患者不利的妊娠和胎儿结局有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Course and outcome of pregnancy in women with Alport syndrome
Pregnancy in patients with CKD is associated with maternal and fetal risks.Purpose. To evaluate course and outcome of pregnancy in Alport syndrome women.Material and methods. Single-center retrospective study included 88 women with genetically confirmed disease. The information about clinical data at conception, course of pregnancy, delivery (preterm delivery <37 gestation weeks; early preterm delivery <34 gestation weeks), fetus characteristics (intrauterine fetal growth restriction: height <2 z-score for gestation age; small for gestation age: weight <2 z-score) were obtained from medical charts and a cross-sectional survey of women.Results. Information about 117 term pregnancies (2 — in 26, 3 — in 3 patients) was obtained. The 1/3 of women (q=0.37) had complications of pregnancy: proteinuria (q=0.23), blood hypertension (q=0.1), threat of miscarriage (q=0.21). Preterm and early preterm delivery were seen in 1/4 of women (q=0.26), including early preterm in 3% of cases. Intrauterine fetal growth restriction and small for gestation age were recorded in 9% and 11% neonates, respectively; 7% of babies required a neonatal intensive care unit stay. Proteinuria was the risk factor for preeclampsia (OR=42.35 3±1.1; p<0.001), preterm delivery (OR=11.8±0.5; p<0.001), intrauterine fetal growth restriction (OR=12.2±0.7; p<0.001), small for gestation age (OR=7.2±0.6; p<0.001).Conclusion. The risk of preeclampsia and fetal growth restriction in women with Alport syndrome and normal kidney function appears comparable to that in the general population. But the disease should be considered as a potential risk factor for preterm delivery. Proteinuria is associated with unfavorable pregnancy and fetal outcome in Alport syndrome.
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