Interrelationship between IgA nephropathy and pregnancy. The rates of spontaneous abortion, normal delivery, safe infant birth, and perinatal death were 9%, 66%, 87%, and 4%, respectively. Perinatal fetal mortality was higher after pregnancy in women with pre-pregnancy creatinine clearance less than 70 ml/min compared to women with greater than 70 ml/min (14% vs. 3%,
P<0.001). Perinatal fetal mortality was also higher in women with pre-pregnancy blood pressure consistently above 140/90 mmHg than in women with blood pressure below 140/90 mmHg (33% vs. 1%, P<0.001). These data were collected from 1970 to 1988, but the stratified data showed that most of the adverse outcomes occurred in the 1970s, when the data showed a 9% perinatal fetal mortality rate, but 0% in the 1980s. After three years or more of continuous follow-up of 85 of these pregnancies, the rates of decreased glomerular filtration rate, increased blood pressure, and increased proteinuria were found to be 19,
11 and
7 percent, respectively. The natural progression of disease after pregnancy was similar in most women with IgA nephropathy as in women without conception, but in five women with IgA nephropathy pregnancy accelerated the deterioration of renal function and eventually progressed rapidly to end-stage renal disease or near end-stage renal disease. If women with IgA nephropathy have normal blood pressure and a creatinine clearance greater than 70 ml/min before pregnancy, they may not be concerned about the problems associated with conception because pregnancy with normal blood pressure and creatinine clearance greater than 70 ml/min does not have a significant impact on the progression of the disease in pregnant patients.