Pregnancy outcomes in patients with chronic kidney disease：a Meta analysis

Li Yu-ye; Zhu Qing-nan; Sun Yu; Wen Qing-si; Shi Yan; Yan Ze-wen; Lin Hong-li; Wang Da-peng; He Jun-jun

doi:10.3969/j.issn.1671-2390.2024.11.005

Journal of Clinical Nephrology > 2024 > 24(11): 906-921. > DOI: 10.3969/j.issn.1671-2390.2024.11.005

Li Yu-ye, Zhu Qing-nan, Sun Yu, Wen Qing-si, Shi Yan, Yan Ze-wen, Lin Hong-li, Wang Da-peng, He Jun-jun. Pregnancy outcomes in patients with chronic kidney disease：a Meta analysis[J]. Journal of Clinical Nephrology, 2024, 24(11): 906-921. DOI: 10.3969/j.issn.1671-2390.2024.11.005

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Pregnancy outcomes in patients with chronic kidney disease：a Meta analysis

1.
First Affiliated Hospital, Dalian Medical University,Dalian 116011, China
2.
College of Integrated Traditional Chinese & Western Medicine, Dalian Medical University,Dalian 116044, China
3.
Donggang Central Hospital，Donggang 118300，China

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Corresponding author:
Wang Da-peng, Email：bobowdp@163.com
Received Date: November 23, 2023

Graphical Abstract

Abstract

Abstract

Objective
To systematically evaluate the impact of chronic kidney disease (CKD) on pregnancy outcomes in pregnant patients.
Methods
Computer searching was conducted within the databases of MEDLINE, EMBASE, WANFANG DATA, China National Knowledge Infrastructure (CNKI) and China Biomedical Literature Database (CBM) from the establishment to July 2023 to identify the relevant literature items on the impact of CKD on pregnancy outcomes in pregnant patients. Two researchers independently screened the literature, extracted data and evaluated the quality of the included studies. Meta-analysis was performed with Review Manager 5.3 and STATA 17.0 software.
Results
A total of 15 case-control and cohort studies, including 2,785,115 subjects, were included for final analysis. The results of Meta-analysis demonstrated the following adverse pregnancy outcomes: CKD elevated the risk of adverse pregnancy outcomes, including preeclampsia (OR=2.68, 95%CI:1.47-4.89), gestational hypertension (OR=6.29, 95%CI:2.58-15.32), preterm birth (OR=4.62, 95%CI:2.78-7.67), small for gestational age (OR=1.54, 95%CI:1.24-1.91) and low birth weight (OR=2.44, 95%CI:1.78-3.35). CKD stage 3-5 patients were more prone to severe preeclampsia (OR=2.31, 95%CI:1.35-3.94), preterm birth (OR=5.06, 95%CI:3.28-7.79), small for gestational age (OR=3.85, 95%CI:1.91-7.76), low birth weight (OR=2.90, 95%CI:1.37-6.13) and fetal mortality (OR=3.41, 95%CI:1.33-8.73) as compared with CKD stage 1-2 counterparts. Pregnant patients with massive proteinuria were more prone to severe preeclampsia (OR=2.76, 95%CI:1.89-4.04), gestational hypertension (OR=2.38, 95%CI:1.62-3.50), preterm birth (OR=3.84, 95%CI:2.69-5.47), low birth weight (OR=2.38, 95%CI:1.62-3.50) and fetal mortality (OR=2.45, 95%CI:1.44-4.17) as compared with those with mild proteinuria.
Conclusion
CKD elevates the risk of adverse pregnancy outcomes, including preeclampsia, gestational hypertension, preterm birth, small for gestational age and low birth weight. Pregnant patients with CKD stage 3-5 or massive proteinuria (≥1 g) are more prone to adverse pregnancy outcomes as compared with those with CKD stage 1-2 or mild proteinuria (<1 g).
- Chronic kidney disease,
- Pregnancy,
- Pregnancy outcome,
- Meta-analysis

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References (34)

References

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Pregnancy outcomes in patients with chronic kidney disease：a Meta analysis