title: Pregnancy outcome in women with chronic kidney disease: a prospective cohort study.
abstract: OBJECTIVE
  To evaluate pregnancy outcome in women with chronic kidney disease (CKD) or proteinuria in early pregnancy with concomitant risk for preeclampsia (PE).
  
  
  METHODS
  Thirty-six women with CKD (Cr > 100 μmol/L at booking or Cr > 125 μmol/L prepregnancy or proteinuria ≥ 500 mg/24 hours at booking) and 30 women with proteinuria (≥2+) and known clinical risk for PE were enrolled at 14(+0) to 21(+6) weeks. Pregnancy outcomes were assessed.
  
  
  RESULTS
  Women with mild CKD (prepregnancy Cr < 125 µmol/Cr > 100 µmol at booking; n = 22) had high rates of preeclampsia (40%), preterm delivery (<37 weeks' gestation; 54%), SGA infants (<10th adjusted centile; 64%)and perinatal death (5%). Women with moderate/severe CKD (prepregnancy creatinine > 125 µmol; n = 14) had poor perinatal outcomes: preterm delivery (86%) and perinatal death (14%). Women with proteinuria (≥2+) and concomitant risk of PE also had high rates of pre-eclampsia (60%), preterm delivery (40%), and SGA infants (27%).
  
  
  CONCLUSIONS
  Pregnancy complications for women with CKD remain high. Women with risk factors for PE with proteinuria (≥2+) at booking are also high-risk.
authors.affiliation: Maternal and Fetal Research Unit, Division of Reproduction and Endocrinology, King's College London School of Biomedical and Health Sciences, London, UK. kate.bramham@kcl.ac.uk
authors.forename: Kate
authors.initials: K
authors.lastname: Bramham
authors.forename: Annette L
authors.initials: AL
authors.lastname: Briley
authors.forename: Paul T
authors.initials: PT
authors.lastname: Seed
authors.forename: Lucilla
authors.initials: L
authors.lastname: Poston
authors.forename: Andrew H
authors.initials: AH
authors.lastname: Shennan
authors.forename: Lucy C
authors.initials: LC
authors.lastname: Chappell
mesh_terms: D015331:Cohort Studies; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology*; D011256:Pregnancy Outcome; D011446:Prospective Studies; D011507:Proteinuria / Q000209:etiology*; D051436:Renal Insufficiency, Chronic / Q000150:complications*