Kidney Week

Abstract: FR-PO860

Urinary Neutrophil Gelatinase-Associated Lipocalin (NGAL) as a Marker of Disease Activity and Pregnancy-Related Adverse Outcomes in Pregnant Women with Inflammatory Bowel Disease

Session Information

• Women's Health and Kidney Diseases
  November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Women's Health and Kidney Diseases

• 2200 Women's Health and Kidney Diseases

Authors

• Elayan, Nour Tareq, Shaare Zedek Medical Center, Jerusalem, Jerusalem, Israel

Nour Tareq Elayan,

• Shavit, Linda, Shaare Zedek Medical Center, Jerusalem, Jerusalem, Israel

Linda Shavit,

Background

Control of disease activity in pregnant women with inflammatory bowel disease (IBD) is crucial as an uncontrolled disease is associated with higher risks of adverse pregnancy outcomes for both the mother and newborn. Human neutrophil gelatinase-associated lipocalin (NGAL) is an acceptable biomarker in some pathological conditions such as acute and chronic kidney injuries and high levels of NGAL were observed in the colon, serum, and stool of patients with IBD. In pregnancy, first-trimester NGAL was found to be an early marker of late-onset preeclampsia. However, no data exists on urinary NGAL in pregnant women with IBD.

Methods

The study recruited women with (IBD) who attended the IBDMOM clinic for antenatal and postnatal follow-up. The correlation of urinary NGAL levels with baseline clinical characteristics and its predictive capacity for pregnancy-related adverse outcomes such as preterm birth, preeclampsia, stillbirth, low-birth weight, and IBD flares were assessed by univariate and multivariate stepwise regression analyses.

Results

The median age of patients was 28 years and the median duration of IBD at the time of conception was 6 years. A total of 252 urine samples (172 samples from patients with Crohn's disease, 77 with ulcerative colitis, and 3 with unclassified IBD) were examined. Urinary NGAL measurements were obtained from 192 pregnancies, throughout the different gestational periods (1^st trimester n = 90; 2^nd trimester n = 111; 3^rd trimester n = 92). Urinary NGAL levels were not significantly higher in patients with active IBD compared with inactive IBD (median 47.7 ± 4.7 ng/mL vs. 52.8 ± 3.98 ng/mL, p = 0.242).
Forty-nine patients reached secondary outcomes (27, 8 and 14 had preterm deliveries, abortions, and either preeclampsia, IUGR, and stillbirth, respectively). There was no statically significant correlation between urinary NGAL levels and obstetric adverse outcomes.
However, the incidence of cesarean sections, treatment regimen changes and hospital admissions during pregnancy were significantly higher in patients with active IBD (p = 0.001).

Conclusion

Our data suggest limited predictive capacity of urinary NGAL levels for predicting disease flares or obstetric adverse outcomes in pregnant women with IBD. However, the role of serum NGAL in this patients population remains to be elucidated.

Funding

• Private Foundation Support