Pre-pregnancy counselling for women with chronic kidney disease: a retrospective analysis of nine years-experience

详细信息    查看全文

• 作者：Kate S Wiles ; Kate Bramham ; Alina Vais ; Kate R Harding ; Paramit Chowdhury…
• 关键词：Chronic kidney disease (CKD) ; Pregnancy ; Counselling ; Experience ; Multidisciplinary
• 刊名：BMC Nephrology
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：16
• 期：1
• 全文大小：369 KB
• 参考文献：1. Williams, D, Davison, J (2008) Chronic kidney disease in pregnancy. BMJ 336: pp. 211-5 CrossRef
  2. Nevis, IF, Reitsma, A, Dominic, A, McDonald, S, Thabane, L, Akl, EA (2011) Pregnancy outcomes in women with chronic kidney disease: A systematic review. Clin J Am Soc Nephrol 6: pp. 2587-98 CrossRef
  3. Bramham, K, Lightstone, L (2012) Pre-pregnancy counselling for women with chronic kidney disease. J Nephrol 25: pp. 450-9 CrossRef
  4. Piccoli, GB, Conijn, A, Attini, R, Biolcati, M, Bossotti, C, Consiglio, V (2011) Pregnancy in chronic kidney disease: Need for a common language. Evid Based Med 4: pp. 17
  5. Davison, JM, Nelson-Piercy, C, Kehoe, S, Baker, P (2008) Renal disease in pregnancy: consensus views arising from the 54th study group. RCOG Press, London CrossRef
  6. Cantwell, R, Clutton-Brock, T, Cooper, G, Dawson, A, Drife, J, Garrod, D (2011) Saving mothers-lives. Reviewing maternal deaths to make motherhood safer: 2006-008. BJOG 118: pp. 1-203
  Hypertension in pregnancy: the management of hypertensive disorders during pregnancy. NICE Clinical Guideline 107, London
  Crossing the quality chasm: A new health system for the 21st century. National Academy Press, Washington, D.C.
  7. Weems, GH, Onwuegbuzie, AJ (2001) The impact of midpoint responses and reverse coding on survey data. Meas Eval Couns Dev 34: pp. 166
  8. Neuendorf, KA (2002) The content analysis guidebook. Sage Publications, Thousand Oaks, CA
  9. UK WHO neonatal and infant close monitoring charts [http://www.rcpch.ac.uk/child-health/research-projects/uk-who-growth-charts/uk-who-growth-chart-resources-0-4-years/uk-who-0]
  10. Soh, MC, Pasupathy, D, Gray, G, Nelson-Piercy, C (2013) Persistent antiphospholipid antibodies do not contribute to adverse pregnancy outcomes. Rheumatology 52: pp. 1642-7 CrossRef
  11. Coresh, J, Selvin, E, Stevens, LA, Manzi, J, Kusek, JW, Eggers, P (2007) Prevalence of chronic kidney disease in the United States. JAMA 298: pp. 2038-47 CrossRef
  12. Mathews, TJ, Hamilton, BE (2009) Delayed childbearing: More women are having their first child later in life. US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistic.
  13. Kelly, T, Yang, W, Chen, CS, Reynolds, K, He, J (2008) Global burden of obesity in 2005 and projections to 2030. Int J Obes 32: pp. 1431-7 CrossRef
  14. Fischer, MJ (2007) Chronic kidney disease and pregnancy: Maternal and fetal outcomes. Adv Chronic Kidney Dis 14: pp. 132-45 CrossRef
  15. Piccoli, GB, Attini, R, Vasario, E, Conijn, A, Biolcati, M, D’Amico, F (2010) Pregnancy and chronic kidney disease: A challenge in all CKD stages. Clin J Am Soc Nephrol 5: pp. 844-55 CrossRef
  16. Katz, AI, Davison, JM, Hayslett, JP, Singson, E, Lindheimer, MD (1980) Pregnancy in women with kidney disease. Kidney Int 18: pp. 192-206 CrossRef
  17. Galdo, T, Gonzalez, F, Espinoza, M, Quintero, N, Espinoza, O, Herrera, S (2005) Impact of pregnancy on the function of transplanted kidneys. Transplant Proc 37: pp. 1577-9 CrossRef
  18. Munkhaugen, J, Lydersen, S, Romundstad, PR, Wider?e, T-E, Vikse, BE, Hallan, S (2009) Kidney function and future risk for adverse pregnancy outcomes: A population-based study from HUNT II. Norway Nephrol Dial Transplant 24: pp. 3744-50 CrossRef
  19. Sibai, BM, Anderson, GD (19
• 刊物主题：Nephrology; Internal Medicine;
• 出版者：BioMed Central
• ISSN：1471-2369

文摘

Background Women with chronic kidney disease have an increased risk of maternal and fetal complications in pregnancy. Pre-pregnancy counselling is recommended but the format of the counselling process and the experience of the patient have never been assessed. This study examines the experience of women with chronic kidney disease attending pre-pregnancy counselling and evaluates their pregnancy outcomes. Methods This is a cross-sectional assessment of 179 women with chronic kidney disease attending a pre-pregnancy counselling clinic (2003-011) with retrospective evaluation of aetiology, comorbidity, treatment and adverse pregnancy outcome compared with 277 hospital controls. It includes an analysis of descriptive data and free text content from 72 questionnaire responders. Results 65/72 (90%) of women found the clinic informative. 66 women (92%) felt that the consultation had helped them decide about pursuing pregnancy. 12 women (17%) found the multidisciplinary process intimidating. Free text comments supported the positive nature of the counselling experience, but also highlighted issues of access and emotional impact. Adverse pregnancy outcome rates were significantly higher in women with chronic kidney disease: 7/35 (20%) had pre-eclampsia (p--.001), 8/35 (23%) infants were small for gestational age (p--.001), 11/35 (31%) had preterm deliveries ( Conclusions Women with a diverse range of renal disease severity and complexity attend pre-pregnancy counselling. Factors affecting pregnancy include hypertension, proteinuria and teratogenic medication. It is important to be able to inform women of the risks to them and their babies before pregnancy in order to facilitate informed-decision making. Most women with chronic kidney disease attending a pre-pregnancy counselling clinic report a positive experience.