Diabetic kidney disease and pregnancy outcomes: a systematic review

IF 0.4 Q4 ENDOCRINOLOGY & METABOLISM British Journal of Diabetes Pub Date : 2021-10-20 DOI:10.15277/bjd.2021.306
S. Gleeson, S. Svetitsky, C. Frise
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引用次数: 1

Abstract

Introduction: We systematically reviewed all relevant literature on diabetic kidney disease (DKD) and pregnancy published in the last 20 years to provide accurate and up-to-date information to inform family planning and maternal care. Methods: A systematic review was completed in PubMed and Embase. Papers reporting maternal, fetal or renal outcomes of pregnant women with DKD published between 2001 and 2020 were included. Results: 799 potentially relevant articles were identified, 731 of which were excluded on abstract alone. 68 full-text articles were reviewed and 15 papers were included as they met the selection criteria but were heterogeneous for size, study setting and years studied. The definition of DKD varied between papers and changed over time. 843 women with 873 pregnancies were included. There were high rates of pre-eclampsia and caesarean section, up to 64% and 100% respectively. Prematurity and neonatal intensive care admission were common, reported in up to 100% and 75%, respectively. Maternal and fetal complications were more common with more severe proteinuria and renal impairment. Pregnancy did not hasten progression of DKD. Discussion: Adverse pregnancy outcomes are frequently encountered and correlate with degree of proteinuria and renal impairment. This information enables individualised risk stratification when a woman is considering pregnancy.
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糖尿病肾病与妊娠结局:系统综述
前言:我们系统地回顾了近20年来关于糖尿病肾病(DKD)和妊娠的所有相关文献,为计划生育和孕产妇保健提供准确和最新的信息。方法:在PubMed和Embase中完成系统评价。纳入了2001年至2020年间发表的关于DKD孕妇的母体、胎儿或肾脏结局的论文。结果:799篇可能相关的文章被识别出来,其中731篇被单独排除在摘要之外。68篇全文文章被审查,15篇论文被纳入,因为它们符合选择标准,但在大小、研究环境和研究年份方面存在异质性。DKD的定义在不同的论文中有所不同,并且随着时间的推移而变化。共纳入843名怀孕妇女,共873名。先兆子痫和剖宫产率较高,分别高达64%和100%。早产和新生儿重症监护住院很常见,分别高达100%和75%。伴严重蛋白尿和肾功能损害的母胎并发症更为常见。妊娠未加速DKD的进展。讨论:不良妊娠结局是经常遇到的,并与蛋白尿和肾功能损害的程度有关。当妇女考虑怀孕时,这一信息可以实现个体化的风险分层。
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来源期刊
British Journal of Diabetes
British Journal of Diabetes ENDOCRINOLOGY & METABOLISM-
自引率
16.70%
发文量
15
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