IgA 신병증에서 임신의 예후
Pregnancy outcomes of IgA nephropathy
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목적: 본 연구는 IgA 신병증이 병합된 임신에서 산모와 태아의 예후를 알아보고, 임신의 합병증과 관련된 예후인자를 찾기 위함이다. 연구 방법: 1997년에서 2006년 사이에 본원에서 조직검사상 IgA 신병증으로 진단받은 여성 가운데 14명의 산모에서 발생한 20예의 임신을 대상으로 하였다. 이 중 분만한 17예의 산모를 대상으로 내과, 산부인과 및 신생아 의무기록과 검사 소견을 후향적으로 조사하여 통계 분석하였다. 결과: 20예의 임신 중 자연유산이 3예이었고 17예에서 생존아를 분만하였다. 47%에서 중증 자간전증, 53%에서 저출생체중아가 발생하였고, 59%에서 37주 이전에 조산하였다. 그러나 조산의 대부분은 34주 이후에 발생하였고 신생아는 모두 생존하였다. 임신 전에 비하여 분만 후에 혈압의 유의한 상승이 관찰되었다. 결론: IgA 신병증 환자에서 임신은 금기는 아니지만 자간전증, 조산 및 저출생체중아의 빈도가 증가하므로 고위험 임신에 준한 면밀한 산전관리가 요구된다.
Abstract
Objective: We performed this study to evaluate maternal and fetal outcomes of pregnancies with IgA nephropathy. Methods: We reviewed 20 pregnancies occurred in 14 women who were diagnosed as IgA nephropathy with the method of renal biopsy between 1997 and 2006. We used clinical and laboratory data from medical records and statistic analysis using SPSS 15.0. Results: Of 20 prenancies, there were 17 live births and 3 spontaneous abortions. There was no stillbirth and congenital anomaly. We found severe preeclampsia in 47%, low birth weight in 53% and preterm birth (comprising medical indications) in 59%. But most were late preterm birth and all were alive. Blood pressure was elevated after delivery compared with pre-pregnancy. Conclusion: Although pregnancy is not contraindicated in IgA nephropathy, it is associated with significant complications comprising preeclampsia, preterm birth and low birth weight.
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