Pregnancy outcome in women with reflux nephropathy and the inheritance of vesico-ureteric reflux

Aust N Z J Obstet Gynaecol. 2000 Aug;40(3):280-5. doi: 10.1111/j.1479-828x.2000.tb03335.x.

Abstract

In women with reflux nephropathy, we investigated whether pre-existing hypertension and impaired renal function influence the rates of preeclampsia, renal function deterioration and preterm birth. The infants were investigated for vesico-ureteric reflux (VUR). A prospective audit of 54 pregnancies in 46 women with reflux nephropathy was performed. Preeclampsia complicated 24% of pregnancies and was increased in women with pre-existing hypertension (42%) compared with normotensive women (14%), (RR 3.0 (95% CI 1.1-7.8)). Nine (18%) women experienced deterioration in renal function during pregnancy Women with mild or moderate renal impairment were at increased risk of renal function deterioration (RR 12.7 (95% CI 1.6-98.5); RR 19.8 (95% CI 2.6-155)), respectively A third of infants were delivered preterm. The risk of preterm birth was increased if the mother had pre-existing hypertension (p = 0.01) or moderate renal impairment (p = 0.002). Seventeen (43%) of the 40 infants who underwent micturating cystourethrography had VUR, consistent with autosomal dominant inheritance with reduced penetrance. In reflux nephropathy, pre-existing hypertension was associated with an increased risk of preeclampsia and pre-existing renal impairment with deterioration in renal function. Infants of women with reflux nephropathy should be screened for VUR.

Publication types

  • Comparative Study

MeSH terms

  • Analysis of Variance
  • Eclampsia / diagnosis
  • Eclampsia / epidemiology
  • Female
  • Humans
  • Hypertension / diagnosis
  • Hypertension / epidemiology
  • Incidence
  • Infant, Newborn
  • Kidney Papillary Necrosis / diagnosis*
  • Kidney Papillary Necrosis / epidemiology
  • New Zealand / epidemiology
  • Pre-Eclampsia / diagnosis
  • Pre-Eclampsia / epidemiology
  • Pregnancy
  • Pregnancy Complications / diagnosis*
  • Pregnancy Complications / epidemiology
  • Pregnancy Outcome*
  • Probability
  • Prospective Studies
  • Risk Assessment
  • Statistics, Nonparametric
  • Vesico-Ureteral Reflux / congenital
  • Vesico-Ureteral Reflux / diagnosis*
  • Vesico-Ureteral Reflux / epidemiology