Kidney Week

Abstract: TH-PO761

International Pregnancy Outcomes in Alport Syndrome (COL4A3-5 Related Disease) vs. CKD in General

Session Information

• Sex and Reproductive Factors in Kidney Health
  November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
  Abstract Time: 10:00 AM - 12:00 PM

Category: Women's Health and Kidney Diseases

• 2100 Women's Health and Kidney Diseases

Authors

• Gosselink, Margriet, Universitair Medisch Centrum Utrecht - Locatie Wilhelmina Kinderziekenhuis, Utrecht, Utrecht, Netherlands

Margriet Gosselink,

• Snoek, Rozemarijn, Universitair Medisch Centrum Utrecht - Locatie Wilhelmina Kinderziekenhuis, Utrecht, Utrecht, Netherlands

Rozemarijn Snoek,

• van Bakel, Sofia Petra José, Universitair Medisch Centrum Utrecht - Locatie Wilhelmina Kinderziekenhuis, Utrecht, Utrecht, Netherlands

Sofia Petra José van Bakel,

• Cerkauskaite, Agne, Vilniaus universiteto ligonine Santaros klinikos, Vilnius, Lithuania

Agne Cerkauskaite,

• Cerkauskiene, Rimante, Vilniaus universiteto ligonine Santaros klinikos, Vilnius, Lithuania

Rimante Cerkauskiene,

• Miglinas, Marius, Vilniaus universiteto ligonine Santaros klinikos, Vilnius, Lithuania

Marius Miglinas,

• Tory, Kalman, Semmelweis Egyetem Klinikai Kozpont, Budapest, Budapest, Hungary

Kalman Tory,

• Claes, Kathleen, Katholieke Universiteit Leuven Universitaire Ziekenhuizen Leuven Campus Gasthuisberg, Leuven, Flanders, Belgium

Kathleen Claes,

• Van Calsteren, Kristel, Katholieke Universiteit Leuven Universitaire Ziekenhuizen Leuven Campus Gasthuisberg, Leuven, Flanders, Belgium

Kristel Van Calsteren,

• Servais, Aude, Hopital universitaire Necker-Enfants malades, Paris, Île-de-France, France

Aude Servais,

• de Jong, Margriet, Universitair Medisch Centrum Groningen, Groningen, Groningen, Netherlands

Margriet de Jong,

• Gillion, Valentine, Universite catholique de Louvain, Louvain-la-Neuve, Walloon Brabant , Belgium

Valentine Gillion,

• Vogt, Liffert, Amsterdam UMC Locatie AMC, Amsterdam, North Holland, Netherlands

Liffert Vogt,

• Furlano, Monica, Fundacio Puigvert, Barcelona, Catalunya, Spain

Monica Furlano,

• Torra, Roser, Fundacio Puigvert, Barcelona, Catalunya, Spain

Roser Torra,

• Mastrangelo, Antonio, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Lombardia, Italy

Antonio Mastrangelo,

• Lely, Titia, Universitair Medisch Centrum Utrecht - Locatie Wilhelmina Kinderziekenhuis, Utrecht, Utrecht, Netherlands

Titia Lely,

• van Eerde, Albertien M., Universitair Medisch Centrum Utrecht - Locatie Wilhelmina Kinderziekenhuis, Utrecht, Utrecht, Netherlands

Albertien M. van Eerde,

Group or Team Name

• ALPART working group

Background

Women with chronic kidney disease (CKD) have high risks of adverse pregnancy outcomes such as preeclampsia, preterm birth, small for gestational age (SGA). Pregnancy outcomes in CKD patients are often presented per CKD-stage without considering etiology of kidney disease. On pregnancy in COL4A3-5 related disease (Alport Syndrome, AS), a prevalent monogenic kidney disease, merely case reports are published. This study investigates pregnancy outcomes in women with AS on a large scale and compare these with pregnancies in general CKD.

Methods

The ALPART-network (mAternaL and fetal PregnAncy outcomes of women with AlpoRT syndrome) was established by 15 centers in Europe and aims to include ∼200 pregnancies. Women with AS and ≥1 pregnancy >20 weeks are included. Data is collected retrospectively from medical records. For these intermediary analyses, a combined adverse pregnancy outcome (cAPO) was established consisting of preterm birth <34 weeks, SGA and NICU admission. Pregnancy outcomes were compared with similar CKD stage 1-2 pregnancies of diverse etiology from the UMC Utrecht outpatient clinic.

Results

Data on 149 AS-pregnancies in 88 women were compared to 104 pregnancies in CKD of various causes. Prepregnancy hypertension was lower (22 vs 53%) and proteinuria levels (>1g/day) were higher (50 vs 33%). AS pregnancy outcomes were significantly better: mean birth weight 3215 gram (SD 678) vs 2735 (913), mean gestational age 38.6 weeks (SD 2.3) vs 37.0 weeks (4.3) and cAPO occurred less frequently (24% vs 40%, p <0.004). Though new-onset/doubling of proteinuria did not differ significantly, missing values hinder interpretation. Mean eGFR was lower after pregnancy vs before (96.1 vs 105.5, p 0.001), but eGFR-slope did not differ significantly after pregnancy (eGFR decline -0.69 ml/min/1.73m2 per year, mean follow up 5.6 years postpartum, p 0.746).

Conclusion

This is the largest cohort of pregnancies in women with AS. Preliminary analyses show favourable outcomes compared to CKD in general. This emphasizes the need for more data on pregnancy outcomes stratified per etiology of CKD, to improve preconception counselling and care.