ORLANDO, Fla.—As chronic kidney disease (CKD) advances, pregnant women are at increased risk of adverse fetal and maternal outcomes, according to study findings presented at the National Kidney Foundation’s 2013 Spring Clinical Meetings.

Compared with pregnant women with mild CKD, those with severe CKD have a significantly higher risk of pre-term delivery and a higher risk of giving birth to an infant that is small for gestation age (SGA), researchers reported. Additionally, the study showed that the subjects with severe CKD experienced more rapid decline in renal function.

Women with severe CKD—defined as an estimated glomerular filtration rate (eGFR) below 30 mL/min/1.73 m2—may benefit from earlier initiation of dialysis to reduce the incidence of adverse maternal and fetal outcomes, the researchers concluded.

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Zichun Feng, MD, and colleagues at Baylor College of Medicine in Houston, retrospectively studied 42 pregnant women: 10 with severe CKD and 32 with mild CKD (eGFR of 30-100 mL/min/1.73 m2) and baseline proteinuria. Preterm delivery (less than 37 weeks’ gestation) occurred in nine women (90%) in the severe CKD group compared with 13 (40.6%) in the mild CKD group. Six women (60%) in the severe CKD group versus four (12.5%) in the mild CKD group gave birth to SGA infants.

The two groups were had similar incidences of preeclampsia and C-section delivery.