title: Pregnancy outcomes in patients with Alport syndrome.
abstract: OBJECTIVE
  To analyze the maternal and obstetric outcomes of patients with Alport syndrome.
  
  
  METHODS
  We describe the pregnancy course of 8 pregnancies of three family members with the autosomal dominant (the rarest) form of Alport syndrome. We also analyzed 10 previously reported pregnancies with other Alport mutations in order to explore risk factors for unfavorable obstetric outcomes and maternal renal deterioration.
  
  
  RESULTS
  In 13 pregnancies (72 %), renal function did not deteriorate permanently. All of these women had pre-pregnancy mild chronic kidney disease (CKD stage G1). In all of them, only a transient increase in proteinuria was recorded and in one case there was a transient decrease in the estimated glomerular filtration rate. In four other pregnancies (22 %), renal function deteriorated following pregnancy. All of them were complicated with pre-eclampsia. One woman had pre-pregnancy CKD-G2A3 and chronic hypertension. Two women had CKD-G1A3 of whom one had pre-pregnancy proteinuria near the nephrotic range. In the fourth case, renal function deterioration was reported without information on the exact pre-pregnancy renal function. In the last case, CKD-G2 was reported after pregnancy without information on CKD stage prior to pregnancy. Severe proteinuria did not imply a permanent renal function deterioration if it developed during pregnancy. Ten pregnancies ended with preterm birth (56 %). Two stillbirths were reported (11 %); however, only one was attributed to maternal health deterioration.
  
  
  CONCLUSIONS
  Data regarding pregnancy outcomes in Alport syndrome is limited. The outcome seems favorable when pre-pregnancy kidney function is normal or near normal and when chronic hypertension/pre-eclampsia is absent.
authors.affiliation: Department of Obstetrics and Gynecology, Emek Medical Center, Afula, Israel. enavy1@gmail.com.
authors.forename: Enav
authors.initials: E
authors.lastname: Yefet
authors.affiliation: Department of Nephrology, Emek Medical Center, Afula, Israel.|Rappaport Faculty of Medicine, Technion, Haifa, Israel.
authors.forename: David
authors.initials: D
authors.lastname: Tovbin
authors.affiliation: Department of Obstetrics and Gynecology, Emek Medical Center, Afula, Israel.|Rappaport Faculty of Medicine, Technion, Haifa, Israel.
authors.forename: Zohar
authors.initials: Z
authors.lastname: Nachum
mesh_terms: D000328:Adult; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007231:Infant, Newborn; D007668:Kidney / Q000503:physiopathology*; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000235:genetics* / Q000473:pathology; D009394:Nephritis, Hereditary / Q000150:complications* / Q000235:genetics* / Q000473:pathology; D011225:Pre-Eclampsia / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000503:physiopathology; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000453:epidemiology* / Q000503:physiopathology; D011507:Proteinuria / Q000097:blood; D012307:Risk Factors
keywords: Alport syndrome; Kidney disease; Nephritis; Pregnancy; Renal failure