A best practice position statement on pregnancy in chronic kidney disease: the Italian Study Group on Kidney and Pregnancy

Gianfranca Cabiddu, Santina Castellino, Giuseppe Gernone, Domenico Santoro, Gabriella Moroni, Michele Giannattasio, Gina Gregorini, Franca Giacchino, Rossella Attini, Valentina Loi, Monica Limardo, Linda Gammaro, Tullia Todros, Giorgina Barbara Piccoli, Gianfranca Cabiddu, Santina Castellino, Giuseppe Gernone, Domenico Santoro, Gabriella Moroni, Michele Giannattasio, Gina Gregorini, Franca Giacchino, Rossella Attini, Valentina Loi, Monica Limardo, Linda Gammaro, Tullia Todros, Giorgina Barbara Piccoli

Abstract

Pregnancy is increasingly undertaken in patients with chronic kidney disease (CKD) and, conversely, CKD is increasingly diagnosed in pregnancy: up to 3 % of pregnancies are estimated to be complicated by CKD. The heterogeneity of CKD (accounting for stage, hypertension and proteinuria) and the rarity of several kidney diseases make risk assessment difficult and therapeutic strategies are often based upon scattered experiences and small series. In this setting, the aim of this position statement of the Kidney and Pregnancy Study Group of the Italian Society of Nephrology is to review the literature, and discuss the experience in the clinical management of CKD in pregnancy. CKD is associated with an increased risk for adverse pregnancy-related outcomes since its early stage, also in the absence of hypertension and proteinuria, thus supporting the need for a multidisciplinary follow-up in all CKD patients. CKD stage, hypertension and proteinuria are interrelated, but they are also independent risk factors for adverse pregnancy-related outcomes. Among the different kidney diseases, patients with glomerulonephritis and immunologic diseases are at higher risk of developing or increasing proteinuria and hypertension, a picture often difficult to differentiate from preeclampsia. The risk is higher in active immunologic diseases, and in those cases that are detected or flare up during pregnancy. Referral to tertiary care centres for multidisciplinary follow-up and tailored approaches are warranted. The risk of maternal death is, almost exclusively, reported in systemic lupus erythematosus and vasculitis, which share with diabetic nephropathy an increased risk for perinatal death of the babies. Conversely, patients with kidney malformation, autosomal-dominant polycystic kidney disease, stone disease, and previous upper urinary tract infections are at higher risk for urinary tract infections, in turn associated with prematurity. No risk for malformations other than those related to familiar urinary tract malformations is reported in CKD patients, with the possible exception of diabetic nephropathy. Risks of worsening of the renal function are differently reported, but are higher in advanced CKD. Strict follow-up is needed, also to identify the best balance between maternal and foetal risks. The need for further multicentre studies is underlined.

Keywords: Chronic kidney disease; Evidence based medicine; Hypertension; Pre-term delivery; Preeclampsia; Pregnancy; Proteinuria.

Conflict of interest statement

Conflict of interest

All authors have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study informed consent is not required.

Figures

Fig. 1
Fig. 1
Minimum follow-up for pregnant CKD patients
Fig. 2
Fig. 2
Minimum follow-up for pregnant hypertensive CKD patients
Fig. 3
Fig. 3
Minimum follow-up for pregnant proteinuric CKD patients
Fig. 4
Fig. 4
Minimum follow-up for pregnant with previous pyelonephritis

References

    1. (1975) Pregnancy and renal disease. Lancet 2(7939):801–802
    1. Duffy D, Reynolds P. Babies born at the threshold of viability: attitudes of paediatric consultants and trainees in South East England. Acta Paediatr. 2011;100(1):42–46. doi: 10.1111/j.1651-2227.2010.01975.x.
    1. Hale TM, Arul M, Veerappan A, Nguyen J, Velastegui Z, Shiffman R, Rajegowda B, Skupski D, Mercado R. Predicting survival of periviable fetuses using NICHD fetal heart rate categories. J Perinat Med. 2011;39(1):47–50. doi: 10.1515/jpm.2010.121.
    1. Stephens BE, Tucker R, Vohr BR. Special health care needs of infants born at the limits of viability. Pediatrics. 2010;125(6):1152–1158. doi: 10.1542/peds.2009-1922.
    1. Hou SH. Pregnancy in women on haemodialysis and peritoneal dialysis. Baillieres Clin Obstet Gynaecol. 1994;8:481–500. doi: 10.1016/S0950-3552(05)80332-3.
    1. Piccoli GB, Conijn A, Consiglio V, et al. Pregnancy in dialysis patients: is the evidence strong enough to lead us to change our counseling policy? Clin J Am Soc Nephrol. 2010;5:62–71. doi: 10.2215/CJN.05660809.
    1. Hladunewich MA, Hou S, Odutayo A, et al. Intensive hemodialysis associates with improved pregnancy outcomes: a Canadian and United States Cohort Comparison. J Am Soc Nephrol. 2014;25(5):1103–1109. doi: 10.1681/ASN.2013080825.
    1. Toma H, Tanabe K, Tokumoto T, Kobayashi C, Yagisawa T. Pregnancy in women receiving renal dialysis or transplantation in Japan: a nationwide survey. Nephrol Dial Transplant. 1999;14:1511–1516. doi: 10.1093/ndt/14.6.1511.
    1. Luders C, Castro MC, Titan SM, et al. Obstetric outcome in pregnant women on long-term dialysis: a case series. Am J Kidney Dis. 2010;56:77–85. doi: 10.1053/j.ajkd.2010.01.018.
    1. Jesudason S, Grace BS, McDonald SP. Pregnancy outcomes according to dialysis commencing before or after conception in women with ESRD. Clin J Am Soc Nephrol. 2014;9:143–149. doi: 10.2215/CJN.03560413.
    1. Piccoli GB, Cabiddu G, Daidone G, et al. The children of dialysis: live-born babies from on-dialysis mothers in Italian epidemiological perspective comparing dialysis, kidney transplantation and the overall population. Nephrol Dial Transplant. 2014;29(8):1578–1586. doi: 10.1093/ndt/gfu092.
    1. Piccoli GB, Postorino V, Cabiddu G, et al. ‘Kidney and Pregnancy Study Group’ of the ‘Italian Society of Nephrology’. Children of a lesser god or miracles? An emotional and behavioural profile of children born to mothers on dialysis in Italy: a multicentre nationwide study 2000–12. Nephrol Dial Transplant. 2015;30(7):1193–1202. doi: 10.1093/ndt/gfv127.
    1. Cabiddu G, Castellino S, Gernone G, et al. Kidney and Pregnancy Study Group of Italian Society of Nephrology. Best practices on pregnancy on dialysis: the Italian Study Group on Kidney and Pregnancy. J Nephrol. 2015;28(3):279–288. doi: 10.1007/s40620-015-0191-3.
    1. . Accessed 20 Sept 2015
    1. Winearls CG, Glassock RJ. Dissecting and refining the staging of chronic kidney disease. Kidney Int. 2009;75:1009–1014. doi: 10.1038/ki.2009.49.
    1. Smyth A, Radovic M, Garovic VD. Women, kidney disease, and pregnancy. Adv Chronic Kidney Dis. 2013;20:402–410. doi: 10.1053/j.ackd.2013.06.004.
    1. Davison JM, Lindheimer MD. Pregnancy and chronic kidney disease. Semin Nephrol. 2011;31:86–99. doi: 10.1016/j.semnephrol.2010.10.008.
    1. Williams D, Davison J. Chronic kidney disease in pregnancy. BMJ. 2008;33:211–215. doi: 10.1136/.
    1. Nevis IF, Reitsma A, Dominic A, et al. Pregnancy outcomes in women with chronic kidney disease: a systematic review. Clin J Am Soc Nephrol. 2011;6:2587–2598. doi: 10.2215/CJN.10841210.
    1. Piccoli GB, Conijn A, Attini R, et al. Pregnancy in chronic kidney disease: need for a common language. J Nephrol. 2011;24:282–299. doi: 10.5301/JN.2011.7978.
    1. Zhang JJ, Ma XX, Hao L, Liu LJ, Lv JC, Zhang H. A systematic review and meta-analysis of outcomes of pregnancy in CKD and CKD Outcomes in pregnancy. Clin J Am Soc Nephrol. 2015;10(11):1964–1978. doi: 10.2215/CJN.09250914.
    1. Lateef A, Petri M. Managing lupus patients during pregnancy. Best Pract Res Clin Rheumatol. 2013;27:435–447. doi: 10.1016/j.berh.2013.07.005.
    1. Stanhope TJ, White WM, Moder KG, et al. Obstetric nephrology: lupus and lupus nephritis in pregnancy. Clin J Am Soc Nephrol. 2012;7:2089–2099. doi: 10.2215/CJN.12441211.
    1. Vora N, Perrone R, Bianchi DW. Reproductive issues for adults with autosomal dominant polycystic kidney disease. Am J Kidney Dis. 2008;5:307–518. doi: 10.1053/j.ajkd.2007.09.010.
    1. Chapman AB, Johnson AM, Gabow PA. Pregnancy outcome and its relationship to progression of renal failure in autosomal dominant polycystic kidney disease. J Am Soc Nephrol. 1994;5(5):1178–1185.
    1. Schneeberger C, Geerlings SE, Middleton P, Crowther CA. Interventions for preventing recurrent urinary tract infection during pregnancy. Cochrane Database Syst Rev. 2012;11:CD009279.
    1. Podymow T, August P, Akbari A. Management of renal disease in pregnancy. Obstet Gynecol Clin N Am. 2010;37(2):195–210. doi: 10.1016/j.ogc.2010.02.012.
    1. Piccoli GB, Clari R, Ghiotto S, et al. Type 1 diabetes, diabetic nephropathy, and pregnancy: a systematic review and meta-study. Rev Diabet Stud. 2013;10:6–26. doi: 10.1900/RDS.2013.10.6.
    1. Piccoli GB, Tavassoli E, Melluzza C, et al. Severe diabetic nephropathy in type 1 diabetes and pregnancy—a case series. Rev Diabet Stud. 2013;10:68–78. doi: 10.1900/RDS.2013.10.68.
    1. Bramham K, Rajasingham D. Pregnancy in diabetes and kidney disease. J Ren Care. 2012;38(Suppl 1):78–89. doi: 10.1111/j.1755-6686.2012.00270.x.
    1. Garovic VD. Hypertension in pregnancy: diagnosis and treatment. Mayo Clin Proc. 2000;75(10):1071–1076. doi: 10.4065/75.10.1071.
    1. Piccoli GB, Fassio F, Attini R, et al. Pregnancy in CKD: whom should we follow and why? Nephrol Dial Transplant. 2012;27(Suppl 3):iii111–iii118. doi: 10.1093/ndt/gfs302.
    1. Morikawa M, Yamada T, Minakami H. Outcome of pregnancy in patients with isolated proteinuria. Curr Opin Obstet Gynecol. 2009;21(6):491–495. doi: 10.1097/GCO.0b013e32833040bf.
    1. Smith MC, Moran P, Ward MK, Davison JM. Assessment of glomerular filtration rate during pregnancy using the MDRD formula. BJOG. 2008;115:109–112. doi: 10.1111/j.1471-0528.2007.01529.x.
    1. Krutzén E, Olofsson P, Bäck SE, Nilsson-Ehle P. Glomerular filtration rate in pregnancy: a study in normal subjects and in patients with hypertension, preeclampsia and diabetes. Scand J Clin Lab Invest. 1992;52:387–392. doi: 10.3109/00365519209088374.
    1. Ahmed SB, Bentley-Lewis R, Hollenberg NK, et al. A comparison of prediction equations for estimating glomerular filtration rate in pregnancy. Hypertens Pregnancy. 2009;28:243–255. doi: 10.1080/10641950801986720.
    1. Alper AB, Yi Y, Rahman M, Webber LS, et al. Performance of estimated glomerular filtration rate prediction equations in preeclamptic patients. Am J Perinatol. 2011;28(6):425–430. doi: 10.1055/s-0030-1268712.
    1. Piccoli GB, Attini R, Vigotti FN, et al. Is renal hyperfiltration protective in chronic kidney disease-stage 1 pregnancies? A step forward unravelling the mystery of the effect of stage 1 chronic kidney disease on pregnancy outcomes. Nephrology (Carlton) 2015;20(3):201–208. doi: 10.1111/nep.12372.
    1. Gülmezoglu M, Villar J, Hofmeyr J, Duley L, Belizan JM. Randomised trials in maternal and perinatal medicine: global partnerships are the way forward. Br J Obstet Gynaecol. 1998;105(12):1244–1247. doi: 10.1111/j.1471-0528.1998.tb10001.x.
    1. Patel D, Nasir S, Elati A, Vernon G, Weeks AD. Historical trends in the timing of informed consent for research into intrapartum complications. BJOG. 2012;119(3):361–365. doi: 10.1111/j.1471-0528.2011.03204.x.
    1. Johnson A. Randomised controlled trials in perinatal medicine: 3. Identifying and measuring endpoints in randomised controlled trials. Br J Obstet Gynaecol. 1997;104(7):768–771. doi: 10.1111/j.1471-0528.1997.tb12017.x.
    1. Barton S. Which clinical studies provide the best evidence? The best RCT still trumps the best observational study. BMJ. 2000;321(7256):255–256. doi: 10.1136/bmj.321.7256.255.
    1. Devereaux PJ, Yusuf S. The evolution of the randomized controlled trial and its role in evidence-based decision making. J Intern Med. 2003;254(2):105–113. doi: 10.1046/j.1365-2796.2003.01201.x.
    1. Barnhart K, Sammel M. The truth is out there: a guide to the pitfalls of interpreting evidence-based medicine in studies of human reproduction. Fertil Steril. 2002;77(2):223–228. doi: 10.1016/S0015-0282(01)03207-1.
    1. Feigin VL, Howard G. The importance of epidemiological studies should not be downplayed. Stroke. 2008;39(1):1–2. doi: 10.1161/STROKEAHA.107.503250.
    1. La Caze A. Evidence-based medicine must be. J Med Philos. 2009;34(5):509–527. doi: 10.1093/jmp/jhp034.
    1. Thompson RP. Causality, mathematical models and statistical association: dismantling evidence-based medicine. J Eval Clin Pract. 2010;16(2):267–275. doi: 10.1111/j.1365-2753.2010.01383.x.
    1. Mansouri A, Cooper B, Shin SM, Kondziolka D. Randomized controlled trials and neurosurgery: the ideal fit or should alternative methodologies be considered? J Neurosurg. 2015;28:1–11.
    1. Hou SH, Grossman SD, Madias NE. Pregnancy in women with renal disease and moderate renal insufficiency. Am J Med. 1985;78:185–194. doi: 10.1016/0002-9343(85)90425-5.
    1. Jungers P, Forget D, Henry-Amar M, et al. Chronic kidney disease and pregnancy. Adv Nephrol Necker Hosp. 1986;15:103–141.
    1. Jones DC, Hayslett JP. Outcome of pregnancy in women with moderate or severe renal insufficiency. N Engl J Med. 1996;335:226–232. doi: 10.1056/NEJM199607253350402.
    1. Bramham K, Briley AL, Seed PT, et al. Pregnancy outcome in women with chronic kidney disease: a prospective cohort study. Reprod Sci. 2011;18:623–630. doi: 10.1177/1933719110395403.
    1. Imbasciati E, Gregorini G, Cabiddu G, et al. Pregnancy in CKD stages 3 to 5: fetal and maternal outcomes. Am J Kidney Dis. 2007;49:753–762. doi: 10.1053/j.ajkd.2007.03.022.
    1. Epstein FH. Pregnancy and renal disease. N Engl J Med. 1996;335:277–278. doi: 10.1056/NEJM199607253350410.
    1. Chopra S, Suri V, Aggarwal N, et al. Pregnancy in chronic renal insufficiency: single centre experience from North India. Arch Gynecol Obstet. 2009;279:691–695. doi: 10.1007/s00404-008-0797-y.
    1. Piccoli GB, Attini R, Vasario E, et al. Pregnancy and chronic kidney disease: a challenge in all CKD stages. Clin J Am Soc Nephrol. 2010;5:844–855. doi: 10.2215/CJN.07911109.
    1. Ibrahim HN, Akkina SK, Leister E, et al. Pregnancy outcomes after kidney donation. Am J Transplant. 2009;9:825–834. doi: 10.1111/j.1600-6143.2009.02548.x.
    1. Reisaeter AV, Røislien J, Henriksen T, et al. Pregnancy and birth after kidney donation: the Norwegian experience. Am J Transplant. 2009;9:820–824. doi: 10.1111/j.1600-6143.2008.02427.x.
    1. Alsuwaida A, Mousa D, Al-Harbi A, et al. Impact of early chronic kidney disease on maternal and fetal outcomes of pregnancy. J Matern Fetal Neonatal Med. 2011;24:1432–1436. doi: 10.3109/14767058.2011.575483.
    1. Limardo M, Imbasciati E, Ravani P, et al. Pregnancy and progression of IgA nephropathy: results of an Italian multicenter study. Am J Kidney Dis. 2010;56:506–512. doi: 10.1053/j.ajkd.2010.03.033.
    1. Bramham K, Lightstone L. Pre-pregnancy counseling for women with chronic kidney disease. J Nephrol. 2012;25:450–459. doi: 10.5301/jn.5000130.
    1. Piccoli GB, Cabiddu G, Attini R, et al. Risk of adverse pregnancy outcomes in women with CKD. J Am Soc Nephrol. 2015;26(8):2011–2022. doi: 10.1681/ASN.2014050459.
    1. Alkhunaizi A, Melamed N, Hladunewich MA. Pregnancy in advanced chronic kidney disease and end-stage renal disease. Curr Opin Nephrol Hypertens. 2015;24(3):252–259. doi: 10.1097/MNH.0000000000000119.
    1. Singh R, Prasad N, Banka A, Gupta A, Bhadauria D, Sharma RK, Kaul A. Pregnancy in patients with chronic kidney disease: maternal and fetal outcomes. Indian J Nephrol. 2015;25(4):194–199. doi: 10.4103/0971-4065.145127.
    1. Feng Z, Minard C, Raghavan R. Pregnancy outcomes in advanced kidney disease. Clin Nephrol. 2015;83(5):272–278. doi: 10.5414/CN108516.
    1. Kendrick J, Sharma S, Holmen J, Palit S, Nuccio E, Chonchol M. Kidney disease and maternal and fetal outcomes in pregnancy. Am J Kidney Dis. 2015;66(1):55–59. doi: 10.1053/j.ajkd.2014.11.019.
    1. Garg AX, Nevis IF, McArthur E, et al. DONOR Network. Gestational hypertension and preeclampsia in living kidney donors. N Engl J Med. 2015;372(2):124–133. doi: 10.1056/NEJMoa1408932.
    1. Pagnoux C, Mahendira D, Laskin CA. Fertility and pregnancy in vasculitis. Best Pract Res Clin Rheumatol. 2013;27:79–94. doi: 10.1016/j.berh.2013.02.002.
    1. Smyth A, Oliveira GH, Lahr BD, et al. A systematic review and meta-analysis of pregnancy outcomes in patients with systemic lupus erythematosus and lupus nephritis. Clin J Am Soc Nephrol. 2010;5:2060–2068. doi: 10.2215/CJN.00240110.
    1. Ritchie J, Smyth A, Tower C, et al. Maternal deaths in women with lupus nephritis: a review of published evidence. Lupus. 2012;21:534–541. doi: 10.1177/0961203311434939.
    1. Biesenbach G, Stoger H, Zazgornik J. Influence of pregnancy on progression of diabetic nephropathy and subsequent requirement of renal replacement therapy in female type 1 diabetic patients with impaired renal function. Nephrol Dial Transplant. 1992;7:105–109. doi: 10.1093/oxfordjournals.ndt.a092077.
    1. Mathiesen ER, Ringholm L, Feldt-Rasmussen B, Clausen P, Damm P. Obstetric nephrology: pregnancy in women with diabetic nephropathy—the role of antihypertensive treatment. Clin J Am Soc Nephrol. 2012;7(12):2081–2088. doi: 10.2215/CJN.00920112.
    1. Bramham K, Rajasingham D. Pregnancy in diabetes and kidney disease. J Ren Care. 2012;38(1):78–89. doi: 10.1111/j.1755-6686.2012.00270.x.
    1. Hawthorne G. Maternal complications in diabetic pregnancy. Best Pract Res Clin Obstet Gynaecol. 2011;25(1):77–90. doi: 10.1016/j.bpobgyn.2010.10.015.
    1. Vohr B. Long-term outcomes of moderately preterm, late preterm, and early term infants. Clin Perinatol. 2013;40(4):739–751. doi: 10.1016/j.clp.2013.07.006.
    1. Asano MK, Dray PB. Retinopathy of prematurity. Dis Mon. 2014;60(6):282–291. doi: 10.1016/j.disamonth.2014.03.009.
    1. Sutherland MR, Bertagnolli M, Lukaszewski MA, Huyard F, Yzydorczyk C, Luu TM, Nuyt AM. Preterm birth and hypertension risk: the oxidative stress paradigm. Hypertension. 2014;63(1):12–18. doi: 10.1161/HYPERTENSIONAHA.113.01276.
    1. Kugelman A, Colin AA. Late preterm infants: near term but still in a critical developmental time period. Pediatrics. 2013;132(4):741–751. doi: 10.1542/peds.2013-1131.
    1. Gubhaju L, Sutherland MR, Black MJ. Preterm birth and the kidney: implications for long-term renal health. Reprod Sci. 2011;18:322–333. doi: 10.1177/1933719111401659.
    1. Sutherland MR, Gubhaju L, Moore L, et al. Accelerated maturation and abnormal morphology in the preterm neonatal kidney. J Am Soc Nephrol. 2011;22:1365–1374. doi: 10.1681/ASN.2010121266.
    1. Hodgin JB, Rasoulpour M, Markowitz GS, D’Agati VD. Very low birth weight is a risk factor for secondary focal segmental glomerulosclerosis. Clin J Am Soc Nephrol. 2009;4:71–76. doi: 10.2215/CJN.01700408.
    1. Carmody JB, Charlton JR. Short-term gestation, long-term risk: prematurity and chronic kidney disease. Pediatrics. 2013;131:1168–1179. doi: 10.1542/peds.2013-0009.
    1. Abitbol CL, Rodriguez MM. The long-term renal and cardiovascular consequences of prematurity. Nat Rev Nephrol. 2012;8(5):265–274. doi: 10.1038/nrneph.2012.38.
    1. Janvier A, Lorenz JM, Lantos JD. Antenatal counseling for parents facing an extremely preterm birth: limitations of the medical evidence. Acta Paediatr. 2012;101(8):800–804. doi: 10.1111/j.1651-2227.2012.02695.x.
    1. Stelloh C, Allen KP, Mattson DL, Lerch-Gaggl A, Reddy S, El-Meanawy A. Prematurity in mice leads to reduction in nephron number, hypertension, and proteinuria. Transl Res. 2012;159(2):80–89. doi: 10.1016/j.trsl.2011.10.004.
    1. Roggero P, Giannì ML, Garbarino F, Mosca F. Consequences of prematurity on adult morbidities. Eur J Intern Med. 2013;24(7):624–626. doi: 10.1016/j.ejim.2013.01.011.
    1. Luyckx VA, Brenner BM. Low birth weight, nephron number, and kidney disease. Kidney Int Suppl. 2005;97:S68–S77. doi: 10.1111/j.1523-1755.2005.09712.x.
    1. Luyckx VA, Brenner BM. The clinical importance of nephron mass. J Am Soc Nephrol. 2010;21:898–910. doi: 10.1681/ASN.2009121248.
    1. Parkinson JR, Hyde MJ, Gale C, Santhakumaran S, Modi N. Preterm birth and the metabolic syndrome in adult life: a systematic review and meta-analysis. Pediatrics. 2013;131(4):e1240–e1263. doi: 10.1542/peds.2012-2177.
    1. de Jong F, Monuteaux MC, van Elburg RM, Gillman MW, Belfort MB. Systematic review ant meta-analysis of preterm birth and later systolic blood pressure. Hypertension. 2012;59:226–234. doi: 10.1161/HYPERTENSIONAHA.111.181784.
    1. Bell R, Glinianaia SV, Tennant PW, Bilous RW, Rankin J. Peri-conception hyperglycaemia and nephropathy are associated with risk of congenital anomaly in women with pre-existing diabetes: a population-based cohort study. Diabetologia. 2012;55:936–947. doi: 10.1007/s00125-012-2455-y.
    1. Piccoli GB, Arduino S, Attini R, et al. Multiple pregnancies in CKD patients: an explosive mix. Clin J Am Soc Nephrol. 2013;8:41–50. doi: 10.2215/CJN.02550312.
    1. Hladunewich MA, Steinberg G, Karumanchi SA, et al. Angiogenic factor abnormalities and fetal demise in a twin pregnancy. Nat Rev Nephrol. 2009;5:658–662. doi: 10.1038/nrneph.2009.154.
    1. Loeffler CL, Macri CJ, Bathgate SL, Freese L, Larsen JW. Autosomal dominant polycystic kidney disease in pregnancy complicated by twin gestation and severe preeclampsia: a case report. J Reprod Med. 2005;50(5):370–372.
    1. Gizzo S, Noventa M, Saccardi C, Paccagnella G, Patrelli TS, Cosmi E, D’Antona D. Twin pregnancy after kidney transplantation: what’s on? A case report and review of literature. J Matern Fetal Neonatal Med. 2014;27(17):1816–1819. doi: 10.3109/14767058.2013.879699.
    1. Abou-Jaoude P, Dubourg L, Bessenay L, et al. What about the renal function during childhood of children born from dialysed mothers? Nephrol Dial Transplant. 2012;27:2365–2369. doi: 10.1093/ndt/gfr617.
    1. Blowey DL, Warady BA. Outcome of infants born to women with chronic kidney disease. Adv Chronic Kidney Dis. 2007;14:199–205. doi: 10.1053/j.ackd.2007.01.014.
    1. Banerjee I, Powis S, Shevlin M, Barnes J, Soo A, Sutcliffe AG. Health outcomes of children born to mothers with chronic kidney disease: a pilot study. Pediatr Rep. 2010;2(1):e7.
    1. Steegers EA, von Dadelszen P, Duvekot JJ, Pijnenborg R. Pre-eclampsia. Lancet. 2010;376:631–644. doi: 10.1016/S0140-6736(10)60279-6.
    1. Masuyama H, Nobumoto E, Okimoto N, Inoue S, Segawa T, Hiramatsu Y. Superimposed preeclampsia in women with chronic kidney disease. Gynecol Obstet Invest. 2012;74(4):274–281. doi: 10.1159/000339935.
    1. Brown MA. Pre-eclampsia in 2014: seven ways to make a difference. Pregnancy Hypertens. 2014;4(4):249–252.
    1. Magee LA, Pels A, Helewa M, Rey E, von Dadelszen P. Canadian hypertensive diagnosis, evaluation, and management of the hypertensive disorders of pregnancy. Disorders of Pregnancy (HDP) Working Group. Pregnancy Hypertens. 2014;4(2):105–145.
    1. Tranquilli AL. Introduction to ISSHP new classification of preeclampsia. Pregnancy Hypertens. 2013;3(2):58–59.
    1. Tranquilli AL, Brown MA, Zeeman GG, Dekker G, Sibai BM. The definition of severe and early-onset preeclampsia. Statements from the International Society for the Study of Hypertension in Pregnancy (ISSHP) Pregnancy Hypertens. 2013;3(1):44–47.
    1. Rezk M, Gamal A, Emara M. Maternal and fetal outcome in de novo preeclampsia in comparison to superimposed preeclampsia: a two-year observational study. Hypertens Pregnancy. 2015;34(2):137–144. doi: 10.3109/10641955.2014.982329.
    1. Berks D, Steegers EA, Molas M, Visser W. Resolution of hypertension and proteinuria after preeclampsia. Obstet Gynecol. 2009;114(6):1307–1314. doi: 10.1097/AOG.0b013e3181c14e3e.
    1. Umans JG. Obstetric nephrology: preeclampsia—the nephrologist’s perspective. Clin J Am Soc Nephrol. 2012;7(12):2107–2113. doi: 10.2215/CJN.05470512.
    1. Lisonkova S, Joseph KS. Incidence of preeclampsia: risk factors and outcomes associated with early- versus late-onset disease. Am J Obstet Gynecol. 2013;209:544.e1–544.e12. doi: 10.1016/j.ajog.2013.08.019.
    1. Arulkumaran N, Lightstone L. Severe pre-eclampsia and hypertensive crises. Best Pract Res Clin Obstet Gynaecol. 2013;27(6):877–884. doi: 10.1016/j.bpobgyn.2013.07.003.
    1. Ciantar E, Walker JJ. Pre-eclampsia, severe pre-eclampsia and hemolysis, elevated liver enzymes and low platelets syndrome: what is new? Womens Health. 2011;7(5):555–569.
    1. Al-Safi Z, Imudia AN, Filetti LC, Hobson DT, Bahado-Singh RO, Awonuga A. Delayed post partum preeclampsia and eclampsia: demographics, clinical course, and complications. Obstet Gynecol. 2011;118(5):1102–1107. doi: 10.1097/AOG.0b013e318231934c.
    1. Mikami Y, Takagi K, Itaya Y, Ono Y, Matsumura H, Takai Y, Seki H. Post-partum recovery course in patients with gestational hypertension and pre-eclampsia. J Obstet Gynaecol Res. 2014;40(4):919–925. doi: 10.1111/jog.12280.
    1. McDonald SD, Han Z, Walsh MW, Gerstein HC, Devereaux PJ. Kidney disease after preeclampsia: a systematic review and meta-analysis. Am J Kidney Dis. 2010;55(6):1026–1039. doi: 10.1053/j.ajkd.2009.12.036.
    1. Wu CC, Chen SH, Ho CH, Liang FW, Chu CC, Wang HY, Lu YH. End-stage renal disease after hypertensive disorders in pregnancy. Am J Obstet Gynecol. 2014;210(2):147. doi: 10.1016/j.ajog.2013.09.027.
    1. Rolfo A, Attini R, Nuzzo AM, et al. Chronic kidney disease may be differentially diagnosed from preeclampsia by serum biomarkers. Kidney Int. 2013;83(1):177–181. doi: 10.1038/ki.2012.348.
    1. . Accessed 15 Sept 2015
    1. Piccoli GB, Gaglioti P, Attini R, et al. Pre-eclampsia or chronic kidney disease? The flow hypothesis. Nephrol Dial Transplant. 2013;28(5):1199–1206. doi: 10.1093/ndt/gfs573.
    1. Parra M, Rodrigo R, Barja P, Bosco C, Fernández V, Muñoz H, Soto-Chacón E. Screening test for preeclampsia through assessment of uteroplacental blood flow and biochemical markers of oxidative stress and endothelial dysfunction. Am J Obstet Gynecol. 2005;193(4):1486–1491. doi: 10.1016/j.ajog.2005.02.109.
    1. Papageorghiou AT, Roberts N. Uterine artery Doppler screening for adverse pregnancy outcome. Curr Opin Obstet Gynecol. 2005;17(6):584–590. doi: 10.1097/01.gco.0000191898.84567.04.
    1. Gaillard R, Arends LR, Steegers EA, Hofman A, Jaddoe VW. Second- and third-trimester placental hemodynamics and the risks of pregnancy complications: the Generation R Study. Am J Epidemiol. 2013;177(8):743–754. doi: 10.1093/aje/kws296.
    1. Kane SC, Dennis AT. Doppler assessment of uterine blood flow in pre-eclampsia: a review. Hypertens Pregnancy. 2015;34(4):400–421. doi: 10.3109/10641955.2015.1074244.
    1. Levine RJ, Maynard SE, Qian C, et al. Circulating angiogenic factors and the risk of preeclampsia. N Engl J Med. 2004;350(7):672–683. doi: 10.1056/NEJMoa031884.
    1. von Dadelszen P, Payne B, Li J, PIERS Study Group et al. Prediction of adverse maternal outcomes in pre-eclampsia: development and validation of the fullPIERS model. Lancet. 2011;377(9761):219–227. doi: 10.1016/S0140-6736(10)61351-7.
    1. Duckitt K, Harrington D. Risk factors for pre-eclampsia at antenatal booking: systematic review of controlled studies. BMJ. 2005;330:565. doi: 10.1136/bmj.38380.674340.E0.
    1. Garovic VD, Wagner SJ, Turner ST et al (2007) Urinary podocyte excretion as a marker for preeclampsia. Am J Obstet Gynecol 196(4):320.e1-7
    1. White WM, Garrett AT, Craici IM, et al. Persistent urinary podocyte loss following preeclampsia may reflect subclinical renal injury. PLoS One. 2014;9(3):e92693. doi: 10.1371/journal.pone.0092693.
    1. Thangaratinam S, Ismail KM, Sharp S, Coomarasamy A, Khan KS. Tests in Prediction of Pre-eclampsia Severity review group. Accuracy of serum uric acid in predicting complications of pre-eclampsia: a systematic review. BJOG. 2006;113(4):369–378. doi: 10.1111/j.1471-0528.2006.00908.x.
    1. Dusse LM, Alpoim PN, Lwaleed BA, et al. Is there a link between endothelial dysfunction, coagulation activation and nitric oxide synthesis in preeclampsia? Clin Chim Acta. 2013;16(415):226–229. doi: 10.1016/j.cca.2012.10.006.
    1. George EM, Granger JP. Endothelin: key mediator of hypertension in preeclampsia. Am J Hypertens. 2011;24(9):964–969. doi: 10.1038/ajh.2011.99.
    1. Bilodeau JF. Review: maternal and placental antioxidant response to preeclampsia—impact on vasoactive eicosanoids. Placenta. 2014;35(Suppl):S32–S38. doi: 10.1016/j.placenta.2013.11.013.
    1. Gennari-Moser C, Khankin EV, Escher G, et al. Vascular endothelial growth factor-A and aldosterone: relevance to normal pregnancy and preeclampsia. Hypertension. 2013;61(5):1111–1117. doi: 10.1161/HYPERTENSIONAHA.111.00575.
    1. Rana S, Powe CE, Salahuddin S, et al. Angiogenic factors and the risk of adverse outcomes in women with suspected preeclampsia. Circulation. 2012;125(7):911–919. doi: 10.1161/CIRCULATIONAHA.111.054361.
    1. Moore Simas TA, Crawford SL, Solitro MJ, Frost SC, Meyer BA, Maynard SE (2007) Angiogenic factors for the prediction of preeclampsia in high-risk women. Am J Obstet Gynecol 197(3):244.e1-8
    1. Duhig KE, Chappell LC, Shennan AH. How placental growth factor detection might improve diagnosis and management of pre-eclampsia. Expert Rev Mol Diagn. 2014;14(4):403–406. doi: 10.1586/14737159.2014.908121.
    1. Verlohren S, Herraiz I, Lapaire O et al (2012) The sFlt-1/PlGF ratio in different types of hypertensive pregnancy disorders and its prognostic potential in preeclamptic patients. Am J Obstet Gynecol 206(1):58.e1-8
    1. Kleinrouweler CE, Wiegerinck MM, Ris-Stalpers C, EBM CONNECT Collaboration et al. Accuracy of circulating placental growth factor, vascular endothelial growth factor, soluble fms-like tyrosine kinase 1 and soluble endoglin in the prediction of pre-eclampsia: a systematic review and meta-analysis. BJOG. 2012;119(7):778–787. doi: 10.1111/j.1471-0528.2012.03311.x.
    1. Powers RW, Jeyabalan A, Clifton RG, Eunice Kennedy Shriver National Institute of Child Health Human Development Maternal-Fetal Medicine Units Network et al. Soluble fms-like tyrosine kinase 1 (sFlt1), endoglin and placental growth factor (PlGF) in preeclampsia among high risk pregnancies. PLoS One. 2010;5(10):e13263. doi: 10.1371/journal.pone.0013263.
    1. Forest JC, Thériault S, Massé J, Bujold E, Giguère Y. Soluble Fms-like tyrosine kinase-1 to placental growth factor ratio in mid-pregnancy as a predictor of preterm preeclampsia in asymptomatic pregnant women. Clin Chem Lab Med. 2014;52(8):1169–1178. doi: 10.1515/cclm-2013-0955.
    1. Gómez-Arriaga PI, Herraiz I, López-Jiménez EA, Gómez-Montes E, Denk B, Galindo A. Uterine artery Doppler and sFlt-1/PlGF ratio: usefulness in diagnosis of pre-eclampsia. Ultrasound Obstet Gynecol. 2013;41(5):530–537. doi: 10.1002/uog.12400.
    1. Piccoli GB, Daidola G, Attini R, et al. Kidney biopsy in pregnancy: evidence for counselling? A systematic narrative review. BJOG. 2013;120:412–427. doi: 10.1111/1471-0528.12111.
    1. Magee LA, Pels A, Helewa M, et al. Diagnosis, evaluation, and management of the hypertensive disorders of pregnancy: executive summary. J Obstet Gynaecol Can. 2014;36:416–438. doi: 10.1016/S1701-2163(15)30588-0.
    1. Abalos E, Duley L, Steyn DW. Antihypertensive drug therapy for mild to moderate hypertension during pregnancy. Cochrane Database Syst Rev. 2014;2:CD002252.
    1. Molvi SN, Mir S, Rana VS, et al. Role of antihypertensive therapy in mild to moderate pregnancy-induced hypertension: a prospective randomized study comparing labetalol with alpha methyldopa. Arch Gynecol Obstet. 2012;285:1553–1562. doi: 10.1007/s00404-011-2205-2.
    1. Rothberger S, Carr D, Brateng D, Hebert M, Easterling TR. Pharmacodynamics of clonidine therapy in pregnancy: a heterogeneous maternal response impacts fetal growth. Am J Hypertens. 2010;23:1234–1240. doi: 10.1038/ajh.2010.159.
    1. Collins R, Yusuf S, Peto R. Overview of randomised trials of diuretics in pregnancy. Br Med J. 1985;290:17–23. doi: 10.1136/bmj.290.6461.17.
    1. Firoz T, Magee LA, MacDonell K, Payne BA, Gordon R, Vidler M, von Dadelszen P. Community Level Interventions for Pre-eclampsia (CLIP) Working Group. BJOG. 2014;121(10):1210–1218. doi: 10.1111/1471-0528.12737.
    1. Nabhan AF, Elsedawy MM. Tight control of mild-moderate pre-existing or non-proteinuric gestational hypertension. Cochrane Database Syst Rev. 2011;7:CD006907.
    1. Magee LA, von Dadelszen P, Rey E, et al. Less-tight versus tight control of hypertension in pregnancy. N Engl J Med. 2015;372(5):407–417. doi: 10.1056/NEJMoa1404595.
    1. Magee LA, CHIPS Study Group, et al. von Dadelszen P, et al. Control of hypertension in pregnancy study randomised controlled trial-are the results dependent on the choice of labetalol or methyldopa? BJOG. 2015
    1. Firoz T, Magee LA, MacDonell K, Payne BA, Gordon R, Vidler M, von Dadelszen P, Community Level Interventions for Pre-eclampsia (CLIP) Working Group Oral antihypertensive therapy for severe hypertension in pregnancy and postpartum: a systematic review. BJOG. 2014;121(10):1210–1218. doi: 10.1111/1471-0528.12737.
    1. Wise J. Tight blood pressure control during pregnancy offers no clear benefits, study finds. BMJ. 2015;2(350):h549. doi: 10.1136/bmj.h549.
    1. Huynh K. Hypertension: tight control of hypertension is safe in pregnant women. Nat Rev Cardiol. 2015;12(4):196. doi: 10.1038/nrcardio.2015.20.
    1. Koren G. Hypertension: ACE inhibitor use in pregnancy—setting the record straight. Nat Rev Cardiol. 2011;9(1):7–8. doi: 10.1038/nrcardio.2011.179.
    1. Lewis G, Maxwell AP. Should women with diabetic nephropathy considering pregnancy continue ACE inhibitor or angiotensin II receptor blocker therapy until pregnancy is confirmed? Diabetologia. 2014;57(5):1082–1083. doi: 10.1007/s00125-014-3188-x.
    1. Cooper WO, Hernandez-Diaz S, Arbogast PG, et al. Major congenital malformations after first-trimester exposure to ACE inhibitors. N Engl J Med. 2006;354:2443–2451. doi: 10.1056/NEJMoa055202.
    1. Li DK, Yang C, Andrade S, Tavares V, Ferber JR. Maternal exposure to angiotensin converting enzyme inhibitors in the first trimester and risk of malformations in offspring: a retrospective cohort study. BMJ. 2011;343:d5931. doi: 10.1136/bmj.d5931.
    1. Vasilakis-Scaramozza C, Aschengrau A, Cabral HJ, Jick SS. Antihypertensive drugs and the risk of congenital anomalies. Pharmacotherapy. 2013;33:476–482. doi: 10.1002/phar.1212.
    1. Al-Balas M, Bozzo P, Einarson A. Use of diuretics during pregnancy. Can Fam Physician. 2009;55(1):44–45.
    1. Henderson JT, Whitlock EP, O'Conner E, Senger CA, Thompson JH, Rowland MG (2014) Low-dose aspirin for the prevention of morbidity and mortality from preeclampsia: a systematic evidence review for the U.S. Preventive Services Task Force. Rockville (MD): Agency for Healthcare Research and Quality (US); 2014 Apr. Report No.: 14-05207-EF-1. US Preventive Services Task Force Evidence Syntheses, formerly Systematic Evidence Reviews
    1. Roberge S, Villa P, Nicolaides K, Giguère Y, Vainio M, Bakthi A, Ebrashy A, Bujold E. Early administration of low-dose aspirin for the prevention of preterm and termpreeclampsia: a systematic review and meta-analysis. Fetal Diagn Ther. 2012;31(3):141–146. doi: 10.1159/000336662.
    1. Bujold E, Roberge S, Lacasse Y, et al. Prevention of preeclampsia and intrauterine growth restriction with aspirin started in early pregnancy: a meta-analysis. Obstet Gynecol. 2010;116(2 Pt 1):402–414. doi: 10.1097/AOG.0b013e3181e9322a.
    1. Roberge S, Villa P, Nicolaides K, et al. Early administration of low-dose aspirin for the prevention of preterm and term preeclampsia: a systematic review and meta-analysis. Fetal Diagn Ther. 2012;31(3):141–146. doi: 10.1159/000336662.
    1. Roberge S, Giguère Y, Villa P, et al. Early administration of low-dose aspirin for the prevention of severe and mild preeclampsia: a systematic review and meta-analysis. Am J Perinatol. 2012;29(7):551–556.
    1. Boldt J. Use of albumin: an update. Br J Anaesth. 2010;104:276–284. doi: 10.1093/bja/aep393.
    1. Jouppila P, Jouppila R, Koivula A. Albumin infusion does not alter the intervillous blood flow in severe pre-eclampsia. Acta Obstet Gynecol Scand. 1983;62(4):345–348. doi: 10.3109/00016348309156236.
    1. Fliser D, Zurbrüggen I, Mutschler E, et al. Coadministration of albumin and furosemide in patients with the nephrotic syndrome. Kidney Int. 1999;55(2):629–634. doi: 10.1046/j.1523-1755.1999.00298.x.
    1. Elwell RJ, Spencer AP, Eisele G. Combined furosemide and human albumin treatment for diuretic-resistant edema. Ann Pharmacother. 2003;37(5):695–700. doi: 10.1345/aph.1C320.
    1. Piccoli GB, Attini R, Vasario E, et al. Vegetarian supplemented low-protein diets. A safe option for pregnant CKD patients: report of 12 pregnancies in 11 patients. Nephrol Dial Transplant. 2011;26(1):196–205. doi: 10.1093/ndt/gfq333.
    1. Piccoli GB, Leone F, Attini R, et al. Association of low-protein supplemented diets with fetal growth in pregnant women with CKD. Clin J Am Soc Nephrol. 2014;9(5):864–873. doi: 10.2215/CJN.06690613.
    1. Cahill LE, Peng CY, Bankovic-Calic N, Sankaran D, Ogborn MR, Aukema HM. Dietary soya protein during pregnancy and lactation in rats with hereditary kidney disease attenuates disease progression in offspring. Br J Nutr. 2007;97:77–84. doi: 10.1017/S0007114507250470.
    1. Barsotti G, Morelli E, Cupisti A, Meola M, Dani L, Giovannetti SA. Low-nitrogen low-phosphorus Vegan diet for patients with chronic renal failure. Nephron. 1996;74:390–394. doi: 10.1159/000189341.
    1. Piccoli GB, Ferraresi M, Deagostini MC, et al. Vegetarian low-protein diets supplemented with keto analogues: a niche for the few or an option for many? Nephrol Dial Transplant. 2013;28:2295–2305. doi: 10.1093/ndt/gft092.
    1. McMullen S. Soya protein during pregnancy—an opportunity to attenuate the progression of chronic kidney disease? Br J Nutr. 2007;97:4–5. doi: 10.1017/S0007114507257812.
    1. Piccoli GB, Clari R, Vigotti FN, et al. Vegan–vegetarian diets in pregnancy: danger or panacea? A systematic narrative review. BJOG. 2015;122(5):623–633. doi: 10.1111/1471-0528.13280.
    1. Craig WJ, Mangels AR. Position of the American Dietetic Association: vegetarian diets. J Am Diet Assoc. 2009;109:1266–1282. doi: 10.1016/j.jada.2009.05.027.
    1. Pawlak R, Parrott SJ, Raj S, Cullum-Dugan D, Lucus D. How prevalent is vitamin B12 deficiency among vegetarians? Nutr Rev. 2013;71:110–117. doi: 10.1111/nure.12001.
    1. Koletzko B, Bauer CP, Bung P, et al. Nutrition in pregnancy—practice recommendations of the Network “Healthy Start-Young Family Network”. Dtsch Med Wochenschr. 2012;137:1366–1372. doi: 10.1055/s-0032-1305076.
    1. Foster M, Herulah UN, Prasad A, Petocz P, Samman S. Zinc status of vegetarians during pregnancy: a systematic review of observational studies and meta-analysis of zinc intake. Nutrients. 2015;7(6):4512–4525. doi: 10.3390/nu7064512.
    1. Brown MA, Holt JL, Mangos GJ, Murray N, Curtis J, Homer C. Microscopic hematuria in pregnancy: relevance to pregnancy outcome. Am J Kidney Dis. 2005;45(4):667–673. doi: 10.1053/j.ajkd.2004.12.023.
    1. Sibai B, Dekker G, Kupferminc M. Pre-eclampsia. Lancet. 2005;365:785–799. doi: 10.1016/S0140-6736(05)71003-5.
    1. Shimizu A, Takei T, Moriyama T, et al. Effect of kidney disease stage on pregnancy and delivery outcomes among patients with immunoglobulin A nephropathy. Am J Nephrol. 2010;32:456–461. doi: 10.1159/000320730.
    1. Ronkainen J, Ala-Houhala M, Autio-Harmainen H, et al. Long-term outcome 19 years after childhood IgA nephritis: a retrospective cohort study. Pediatr Nephrol. 2006;21:1266–1273. doi: 10.1007/s00467-006-0163-x.
    1. Abe S. Pregnancy in IgA nephropathy. Kidney Int. 1991;40(6):1098–1102. doi: 10.1038/ki.1991.320.
    1. Liu Y, Ma X, Lv J, Shi S, Liu L, Chen Y, Zhang H. Risk factors for pregnancy outcomes in patients with IgA nephropathy: a matched cohort study. Am J Kidney Dis. 2014;64(5):730–736. doi: 10.1053/j.ajkd.2014.06.021.
    1. Oh HJ, Han SH, Yoo DE, Kim SJ, Park JT, Kim JK, Yoo TH, Kang SW, Choi KH. Reduced pre-pregnancy proteinuria is associated with improving postnatal maternal renal outcomes in IgA nephropathy women. Clin Nephrol. 2011;76(6):447–454. doi: 10.5414/CN107208.
    1. Zand L, Williams A, Babovic-Vuksanovic D, Nwoko R, Cornell L, Garovic V. The Case | Renal dysfunction in a pregnant patient with IgA nephropathy. Kidney Int. 2014;85(6):1477–1478. doi: 10.1038/ki.2013.322.
    1. Barisoni L, Schnaper HW, Kopp JB. A proposed taxonomy for the podocytopathies: a reassessment of the primary nephrotic diseases. Clin J Am Soc Nephrol. 2007;2(3):529–542. doi: 10.2215/CJN.04121206.
    1. Nishimoto K, Shiiki H, Nishino T, et al. Glomerular hypertrophy in preeclamptic patients with focal segmental glomerulosclerosis. A morphometric analysis. Clin Nephrol. 1999;51(4):209–219.
    1. Kwiatkowski S, Kwiatkowska E, Rzepka R, Kurkiewicz V, Mikołajek-Bedner W, Torbè A. Development of a focal segmental glomerulosclerosis after pregnancy complicated by preeclampsia: case report and review of literature. J Matern Fetal Neonatal Med. 2015;29(10):1566–1569. doi: 10.3109/14767058.2015.1053865.
    1. Lee HS, Kim TS. A morphometric study of preeclamptic nephropathy with focal segmental glomerulosclerosis. Clin Nephrol. 1995;44(1):14–21.
    1. Kambham N, Markowitz GS, Valeri AM, et al. Obesity related glomerulomegaly: an emerging epidemic. Kidney Int. 2001;59:1498–1509. doi: 10.1046/j.1523-1755.2001.0590041498.x.
    1. French NP, Hagan R, Evans SF, Godfrey M, Newnham JP. Repeated antenatal corticosteroids: size at birth and subsequent development. Am J Obstet Gynecol. 1999;180:114–121. doi: 10.1016/S0002-9378(99)70160-2.
    1. Burton PJ, Waddell BJ. Dual function of 11beta-hydroxysteroid dehydrogenase in placenta: modulating placental glucocorticoid passage and local steroid action. Biol Reprod. 1999;60:234–240. doi: 10.1095/biolreprod60.2.234.
    1. van Runnard Heimel PJ, Schobben AF, Huisjes AJ, Franx A, Bruinse HW. The transplacental passage of prednisolone in pregnancies complicated by early-onset HELLP syndrome. Placenta. 2005;26(10):842–845. doi: 10.1016/j.placenta.2004.12.008.
    1. Ronco P, Debiec H. Pathophysiological advances in membranous nephropathy: time for a shift in patient’s care. Lancet. 2015;385(9981):1983–1992. doi: 10.1016/S0140-6736(15)60731-0.
    1. Tomas NM, Beck LH, Jr, Meyer-Schwesinger C, et al. Thrombospondin type-1 domain-containing 7A in idiopathic membranous nephropathy. N Engl J Med. 2014;371(24):2277–2287. doi: 10.1056/NEJMoa1409354.
    1. Packham DK, North RA, Fairley KF, Whitworth JA, Kincaid-Smith P. Membranous glomerulonephritis and pregnancy. Clin Nephrol. 1987;28(2):56–64.
    1. Malik GH, Al-Harbi AS, Al-Mohaya S, et al. Repeated pregnancies in patients with primary membranous glomerulonephritis. Nephron. 2002;91(1):21–24. doi: 10.1159/000057600.
    1. Sethi S, Fervenza FC. Membranoproliferative glomerulonephritis: a new look at an old entity. N Engl J Med. 2012;366:1119–1131. doi: 10.1056/NEJMra1108178.
    1. Surian M, Imbasciati E, Cosci P, et al. Glomerular disease and pregnancy. A study of 123 pregnancies in patients with primary and secondary glomerular diseases. Nephron. 1984;36(2):101–105. doi: 10.1159/000183126.
    1. Malik GH, Al-Mohaya S, Shaikh JF, et al. Repeated pregnancies in patients with non-immunoglobulin a mesangioproliferative glomerulonephritis. Am J Nephrol. 2001;21(5):378–382. doi: 10.1159/000046278.
    1. Kurdoglu M, Kurdoglu Z, Adali E, Soyoral Y, Erkoc R. Successful management of membranoproliferative glomerulonephritis type I in pregnancy. Arch Gynecol Obstet. 2010;281(1):105–109. doi: 10.1007/s00404-009-1071-7.
    1. De Galasso L, Gigante A, Pirozzi N, et al. Acute renal failure and nephrotic syndrome due to membranoproliferative nephritis during the second trimester of pregnancy. Clin Nephrol. 2011;75(5):480–483. doi: 10.5414/CN106584.
    1. Ruiz-Irastorza G, Lima F, Alves J, et al. Increased rate of lupus flare during pregnancy and the puerperium, a prospective study of 78 pregnancies. Br J Rheumatol. 1996;35:133–138. doi: 10.1093/rheumatology/35.2.133.
    1. Huong DL, Wechsler B, Vauthier-Brouzes D, Beaufils H, Lefebvre G, Piette JC. Pregnancy in past or present lupus nephritis: a study of 32 pregnancies from a single centre. Ann Rheum Dis. 2001;60:599–604. doi: 10.1136/ard.60.6.599.
    1. Moroni G, Quaglini S, Banfi G, et al. Pregnancy in lupus nephritis. Am J Kideny Dis. 2002;40:713–720. doi: 10.1053/ajkd.2002.35678.
    1. Moroni G, Ponticelli C. Pregnancy after lupus nephritis. Lupus. 2005;14:89–94. doi: 10.1191/0961203305lu2066oa.
    1. Carmona F, Font J, Moga I, Lazzaro I, Cervera R, Pac V, Balasch L. Class III–IV proliferative lupus nephritis and pregnancy: a study of 42 cases. Am J Reprod Immunol. 2005;53:182–188. doi: 10.1111/j.1600-0897.2005.00263.x.
    1. Zhang L, Abe K, Hashimoto H, Takasaki Y. Pregnancy and fetal outcomes in patients with lupus nephritis. Nihon Rinsho Meneki Gakkai Kaishi. 2007;30:185–192. doi: 10.2177/jsci.30.185.
    1. Imbasciati E, Tincani A, Gregorini G, et al. Pregnancy in women with pre-existing lupus nephritis: predictors of fetal and maternal outcome. Nephrol Dial Transplant. 2009;24:519–525. doi: 10.1093/ndt/gfn348.
    1. Bramham K, Hunt BJ, Bewley S, Germain S, Calatayud I, Khamashta MA, Nelson-Piercy C. Pregnancy outcomes in systemic lupus erythematosus with and without previous nephritis. J Rheumatol. 2011;38:1906–1913. doi: 10.3899/jrheum.100997.
    1. Saavedra MA, Cruz-Reyes C, Vera-Lastra O, et al. Impact of previous lupus nephritis on maternal and fetal outcomes during pregnancy. Clin Rheumatol. 2012;31:813–819. doi: 10.1007/s10067-012-1941-4.
    1. Petri M, Kim MY, Kalunian KC, et al. Combined oral contraceptives in women with systemic lupus erythematosus. N Engl J Med. 2005;353:2550–2558. doi: 10.1056/NEJMoa051135.
    1. Sanchez-Guerrero J, Uribe AG, Jimenez-Santana L, et al. A trial of contraceptive methods in women with systemic lupus erythematosus. N Engl J Med. 2005;353:2539–2549. doi: 10.1056/NEJMoa050817.
    1. Fischer-Betz R, Specker C, Brinks R, Aringer M, Schneider M. Low risk of renal flares and negative outcomes in women with lupus nephritis conceiving after switching from mycophenolate mofetil to azathioprine. Rheumatology (Oxford) 2013;52:1070–1076. doi: 10.1093/rheumatology/kes425.
    1. Ponticelli C, Moroni G. Immunosuppression in pregnant women with systemic lupus erythematosus. Expert Rev Clin Immunol. 2015;11:549–552. doi: 10.1586/1744666X.2015.1033404.
    1. Leroux M, Desveaux C, Parcevaux M, et al. Impact of hydroxychloroquine on preterm delivery and intrauterine growth restriction in pregnant women with systemic lupus erythematosus: a descriptive cohort study. Lupus. 2015;24(13):1384–1391. doi: 10.1177/0961203315591027.
    1. Izmirly PM, Costedoat-Chalumeau N, Pisoni CN, et al. Maternal hydroxychloroquine is associated with a reduced risk of recurrent anti-SSA/Ro-antibody-associated cardiac manifestations of neonatal lupus. Circulation. 2012;126:76–82. doi: 10.1161/CIRCULATIONAHA.111.089268.
    1. Abarientos C, Sperber K, Shapiro DL, et al. Hydroxychloroquine in systemic lupus erythematosus and rheumatoid arthritis and its safety in pregnancy. Expert Opin Drug Saf. 2011;10:705–714. doi: 10.1517/14740338.2011.566555.
    1. Kaaja R, Julkunen H, Ammälä P, Palosuo T, Kurki P. Intravenous immunoglobulin treatment of pregnant patients with recurrent pregnancy losses associated with antiphospholipid antibodies. Acta Obstet Gynecol Scand. 1993;72:63–66. doi: 10.3109/00016349309013355.
    1. Petri M. Immunosuppressive drug use in pregnancy. Autoimmunity. 2013;36:51–56. doi: 10.1080/0891693031000067296.
    1. Perricone R, De Carolis C, Kröegler B, et al. Intravenous immunoglobulin therapy in pregnant patients affected with systemic lupus erythematosus and recurrent spontaneous abortion. Rheumatology (Oxford) 2008;47:646–651. doi: 10.1093/rheumatology/ken046.
    1. Coomarasamy A, Honest H, Papaioannou S, Gee H, Khan KS. Aspirin for prevention of preeclampsia in women with historical risk factors: a systematic review. Obstet Gynecol. 2003;101:1319–1332.
    1. Duley L, Henderson-Smart DJ, Knight M, King JF. Antiplatelet agents for preventing pre-eclampsia and its complications. Cochrane Database Syst Rev. 2007;18(2):CD000492.
    1. Farquharson RG, Quenby S, Greaves M. Antiphospholipid syndrome in pregnancy: a randomized, controlled trial of treatment. Obstet Gynecol. 2002;100:408–413. doi: 10.1097/00006250-200209000-00004.
    1. Ruffatti A, Salvan E, Del Ross T, et al. Treatment strategies and pregnancy outcomes in antiphospholipid syndrome patients with thrombosis and triple antiphospholipid positivity. A European multicentre retrospective study. Thromb Haemost. 2014;112:727–735. doi: 10.1160/TH14-03-0191.
    1. Chakravarty EF, Colon I, Langen ES, et al. Factors that predict prematurity and preeclampsia in pregnancies that are complicated by systemic lupus erythematosus. Am J Obstet Gynecol. 2005;192:1897–1904. doi: 10.1016/j.ajog.2005.02.063.
    1. Chen CW, Jaffe IZ, Karumanchi SA. Pre-eclampsia and cardiovascular disease. SA Cardiovasc Res. 2014;101:579–586. doi: 10.1093/cvr/cvu018.
    1. Galdman D, Tandon A, Ibañez D, Urowitz MB. The effect of lupus nephritis on pregnancy outcome and fetal and maternal complications. J Rheumatol. 2010;37:754–758. doi: 10.3899/jrheum.090872.
    1. Hou S. Pregnancy in chronic renal insufficiency and end-stage renal disease. Am J Kidney Dis. 1999;33:235–252. doi: 10.1016/S0272-6386(99)70296-9.
    1. Clark CA, Spitzer KA, Laskin CA. Decrease in pregnancy loss rates in patients with systemic lupus erythematosus over a 40-year period. J Rheumatol. 2005;32:1709–1712.
    1. Cimaz R, Spence DL, Hornberger L, Silverman ED. Incidence and spectrum of neonatal lupus erythematosus: a prospective study of infants born to mothers with anti-Ro autoantibodies. J Pediatr. 2003;142:678–683. doi: 10.1067/mpd.2003.233.
    1. Clowse ME, Magder LS, Witter F, Petri M. The impact of increased lupus activity on obstetric outcomes. Arthritis Rheum. 2005;52:514–521. doi: 10.1002/art.20864.
    1. Rahman P, Gladman DD, Urowitz MB. Clinical predictors of fetal outcome in systemic lupus erythematosus. J Rheumatol. 1998;25:1526–1530.
    1. McNeil HP, Chesterman CN, Krilis SA. Immunology and clinical importance of antiphospholipid antibodies. Adv Immunol. 1991;49:193–280. doi: 10.1016/S0065-2776(08)60777-4.
    1. Hayslett JP, Lynn RI. Effect of pregnancy in patients with lupus nephropathy. Kidney Int. 1980;18:207–220. doi: 10.1038/ki.1980.129.
    1. Lateef A, Petri M. Managing lupus patients during pregnancy. Best Pract Res Clin Rheumatol. 2013;27:435–447. doi: 10.1016/j.berh.2013.07.005.
    1. Doria A, Bajocchi G, Tonon M, Salvarani C. Pre-pregnancy counselling of patients with vasculitis. Rheumatology. 2008;47:iii13–iii15. doi: 10.1093/rheumatology/kem250.
    1. Pagnoux C, Le Guern V, Goffinet F, et al. Pregnancies in systemic necrotizing vasculitides: report on 12 women and their 20 pregnancies. Rheumatology. 2001;50:953–961. doi: 10.1093/rheumatology/keq421.
    1. Tuin J, Sanders JSF, de Joode AAE, Stegeman C. Pregnancy in women diagnosed with ANCA-Associated Vasculitis: favorable outcome for mother and child. Arthritis Care Res (Hoboken) 2012;64:539–545. doi: 10.1002/acr.21556.
    1. Clowse MEB, Richeson RL, Pieper C, Merkel PA, for the Vasculitis Clinical Research Consortium Pregnancy outcomes among patients with vasculitis. Arthritis Care Res. 2013;65(1370):1374.
    1. Croft AP, Smith SW, Carr S, et al. Successful outcome of pregnancy in patients with anti-neutrophil cytoplasm antibody-associated small vessel vasculitis. Kidney Int. 2015;87:807–811. doi: 10.1038/ki.2014.329.
    1. Sangle SR, Vounotrypidis P, Briley A, et al. Pregnancy out come in patients with sistemi vasculitis: a single-centre marched case-control study. Rheumatology (Oxford) 2015;54:1582–1586. doi: 10.1093/rheumatology/kev018.
    1. Soh MC, Nelson-Piercy C. High-risk pregnancy and the rheumatologist. Rheumatology (Oxford) 2015;54(4):572–587. doi: 10.1093/rheumatology/keu394.
    1. Chakravarty EF, Murray ER, Kelman A, Farmer P. Pregnancy outcomes after maternal exposure to rituximab. Blood. 2011;117(5):1499–1506. doi: 10.1182/blood-2010-07-295444.
    1. Steinke JM, Mauer M. Lessons learned from studies of the natural history of diabetic nephropathy in young type 1 diabetic patients. Pediatr Endocrinol Rev. 2008;5(4):958–963.
    1. Furukawa T, Tokunaga S, Iwashita K, Sato K, Terashima M, Hora K, Oguchi H, Furuta S, Shigematsu H. Diabetic glomerulosclerosis with nephrotic syndrome in early pregnancy. Nippon Jinzo Gakkai shi. 1987;29:541–545.
    1. Biesenbach G, Zazgornik J. Incidence of transient nephrotic syndrome during pregnancy in diabetic women with and without pre-existing microalbuminuria. Br Med J. 1989;299:366–367. doi: 10.1136/bmj.299.6695.366.
    1. Combs CA, Rosenn B, Kitzmiller JL, Khoury JC, Wheeler BC, Miodovnik M. Early-pregnancy proteinuria in diabetes related to preeclampsia. Obstet Gynecol. 1993;82:802–807.
    1. Coletta J, Simpson LL. Maternal medical disease and stillbirth. Clin Obstet Gynecol. 2010;53(3):607–616. doi: 10.1097/GRF.0b013e3181eb2ca0.
    1. Ringholm L, Mathiesen ER, Kelstrup L, Damm P. Managing type 1 diabetes mellitus in pregnancy—from planning to breastfeeding. Nat Rev Endocrinol. 2012;8:659–667. doi: 10.1038/nrendo.2012.154.
    1. Fretts RC. Etiology and prevention of stillbirth. Am J Obstet Gynecol. 2005;193(6):1923–1935. doi: 10.1016/j.ajog.2005.03.074.
    1. Mathiesen ER, Ringholm L, Damm P. Pregnancy management of women with pregestational diabetes. Endocrinol Metab Clin North Am. 2011;40(4):727–738. doi: 10.1016/j.ecl.2011.08.005.
    1. Visintin C, Mugglestone MA, Almerie MQ, Nherera LM, James D, Walkinshaw S, Guideline Development Group Management of hypertensive disorders during pregnancy: summary of NICE guidance. BMJ. 2010;341:c2207. doi: 10.1136/bmj.c2207.
    1. Carr DB, Koontz GL, Gardella C, Holing EV, Brateng DA, Brown ZA, Easterling TR. Diabetic nephropathy in pregnancy: suboptimal hypertensive control associated with preterm delivery. Am J Hypert. 2006;19:513–519. doi: 10.1016/j.amjhyper.2005.12.010.
    1. Niensen LR, Damm P, Mathiesen ER. Improved pregnancy outcome in type 1 diabetic women with microalbuminuria or diabetic nephropathy: effect of intensified antihypertensive therapy? Diabetes Care. 2009;32(1):38–44. doi: 10.2337/dc08-1526.
    1. Jensen DM, Damm P, Ovesen P, Mølsted-Pedersen L, Beck-Nielsen H, Westergaard JG, Moeller M, Mathiesen ER. Microalbuminuria, preeclampsia, and preterm delivery in pregnant women with type 1 diabetes. Diabetes Care. 2010;33:1. doi: 10.2337/dc09-1219.
    1. Yogev Y, Chen R, Ben-Haroush A, Hod M, Bar J. Maternal overweight and pregnancy outcome in women with type-1 diabetes mellitus and different degrees of nephropathy. J Matern Fetal Neonatal Med. 2010;23(9):999–1003. doi: 10.3109/14767050903544744.
    1. Wu M, Wang D, Zand L, et al. Pregnancy outcomes in autosomal dominant polycystic kidney disease: a case-control study. J Matern Fetal Neonatal Med. 2015;29(5):807–812. doi: 10.3109/14767058.2015.1019458.
    1. Chapman AB, Johnson AM, Gabow PA. Pregnancy outcome and its relationship to progression of renal failure in autosomal dominant polycystic kidney disease. J Am Soc Nephrol. 1994;5(5):1178–1185.
    1. Vora N, Perrone R, Bianchi DW. Reproductive issues for adults with autosomal dominant polycystic kidney disease. Am J Kidney Dis. 2008;51(2):307–318. doi: 10.1053/j.ajkd.2007.09.010.
    1. Milutinovic J, Fialkow PJ, Agodoa LY, Phillips LA, Bryant JI. Fertility and pregnancy complications in women with autosomal dominant polycystic kidney disease. Obstet Gynecol. 1983;61(5):566–570.
    1. Backe J, Kristen P, Arlt W, Steck T. Postpartum rupture of a kidney cyst in familial polycystic kidney degeneration and HELLP syndrome. Z Geburtshilfe Neonatol. 1996;200(3):122–126.
    1. Szmigielski W, Klamut M, Caban B, Wieczorek P, Tereszkiewicz J. Superselective arterial embolization in the control of hemorrhage from ruptured cyst in polycystic kidney in pregnancy. Pol Przegl Radiol. 1988;52(2):110–111.
    1. Gigarel N, Frydman N, Burlet P, et al. Preimplantation genetic diagnosis for autosomal recessive polycystic kidney disease. Reprod Biomed Online. 2008;16(1):152–158. doi: 10.1016/S1472-6483(10)60569-X.
    1. Banks N, Bryant J, Fischer R, Huizing M, Gahl WA, Gunay-Aygun M. Pregnancy in autosomal recessive polycystic kidney disease. Arch Gynecol Obstet. 2015;291(3):705–708. doi: 10.1007/s00404-014-3445-8.
    1. Nicolle LE (2012) Urinary tract infection in adults. In: Brenner and Rector’s the kidney, 9th edn. Saunders. ISBN: 978-1-4160-6193-9, 36, pp 1356–1382
    1. Piccoli GB, Colla L, Burdese M, et al. Development of kidney scars after acute uncomplicated pyelonephritis: relationship with clinical laboratory and imaging data at diagnosis. World J Urol. 2006;24:66–73. doi: 10.1007/s00345-005-0044-0.
    1. Piccoli GB, Consiglio V, Deagostini MC, et al. The clinical and imaging presentation of acute “non complicated” pyelonephritis: a new profile for an ancient disease. BMC Nephrol. 2011;15(12):68. doi: 10.1186/1471-2369-12-68.
    1. Lee YJ, Lee JH, Park YS. Risk factors for renal scar formation in infants with first episode of acute pyelonephritis: a prospective clinical study. J Urol. 2012;187(3):1032–1036. doi: 10.1016/j.juro.2011.10.164.
    1. Raz R, Sakran W, Chazan B, et al. Long-term follow-up of women hospitalized for acute pyelonephritis. Clin Infect Dis. 2003;37:1014–1020. doi: 10.1086/377737.
    1. Martinell J, Jodal U, Lidin-Janson G. Pregnancies in women with and without renal scarring after urinary infection in childhood. BMJ. 1990;300:840. doi: 10.1136/bmj.300.6728.840.
    1. Millar LK, Cox SM. Urinary tract infections complicating pregnancy. Infect Dis Clin N Am. 1997;11:13–26. doi: 10.1016/S0891-5520(05)70339-1.
    1. Stamm WE. Management of urinary tract infection in adults. NEJM. 1993;329:1328–1334. doi: 10.1056/NEJM199310283291808.
    1. Castellino S, Cabiddu F, Gernone G et al (2013) Rene e Gravidanza: Suggerimenti di pratica clinica e di applicazione delle Linee-guida. G Ital Nefrol, vol S59, Anno 30, Luglio
    1. Nicolle LE. A practical approach to the management of complicated urinary tract infection. Drugs Aging. 2001;18:243–254. doi: 10.2165/00002512-200118040-00002.
    1. Nowicki B. Urinary tract infection in pregnant women: old dogmas and current concepts regarding pathogenesis. Curr Infect Dis Rep. 2002;4(6):529–535. doi: 10.1007/s11908-002-0041-z.
    1. Nowicki B, Sledzinska A, Samet A, Nowicki S. Pathogenesis of gestational urinary tract infection: urinary obstruction versus immune adaptation and microbial virulence. BJOG. 2011;118(2):109–112. doi: 10.1111/j.1471-0528.2010.02706.x.
    1. Pastore LM, et al. Predictors of urinary tract infection at the first prenatal visit. Epidemiology. 1999;10:282. doi: 10.1097/00001648-199905000-00016.
    1. Kass EH. Bacteriuria and pyelonephritis of pregnancy. Arch Intern Med. 1960;105:194. doi: 10.1001/archinte.1960.00270140016003.
    1. Naeye RL. Causes of the excessive rates of perinatal mortality and prematurity in pregnancies complicated by maternal urinary-tract infections. N Engl J Med. 1979;300:819. doi: 10.1056/NEJM197904123001503.
    1. Mittendorf R. Prevention of preterm delivery and low birth weight associated with asymptomatica bacteriuria. Clin Infect Dis. 1992;14:927. doi: 10.1093/clinids/14.4.927.
    1. Patterson TF. Detection, significance and therapy of bacteriuria in pregnancy. Infect Dis Clin N Am. 1997;11:593. doi: 10.1016/S0891-5520(05)70375-5.
    1. Delzell JE., Jr Urinary tract infections during pregnancy. Am Fam Physician. 2000;61:713.
    1. Sheiner E, Mazor-Drey E, Levy A. Asymptomatic bacteriuria during pregnancy. J Matern Fetal Neonatal Med. 2009;22(5):423–427. doi: 10.1080/14767050802360783.
    1. Smaill FM, Vasquez JC. Antibiotics for asymptomatic bacteriuria in pregnancy. Cochrane Database Syst Rev. 2007;2:CD000490.
    1. Guinto VT, De Guia B, Festin MR, Dowswell T. Different antibiotic regimens for treating asymptomatic bacteriuria in pregnancy (Review) Cochrane Database Syst Rev. 2010;9:CD007855.
    1. Vasquez JC, Abalos E. Treatments for symptomatic urinary tract infections during pregnancy. CochraneDatabase of Systematic Reviews. 2011;1:CD002256.
    1. Gratacòs E. Screening and treatment of asymptomatic bacteriuria in pregnancy prevent pyelonephritis. J Infect Dis. 1994;169:1390. doi: 10.1093/infdis/169.6.1390.
    1. Villar J. Nutritional and antimicrobial interventions to prevent preterm birth: an overview of randomized controlled trials. Obstet Gynecol Surv. 1998;53:575. doi: 10.1097/00006254-199809000-00025.
    1. NICE clinical guideline 62 – 2008
    1. Rouse DJ. Screening and treatment of asymptomatic bacteriuria of pregnancy to prevent pyelonephritis: a cost effectiveness and cost benefit analysis. Obstet Gynecol. 1995;86:119. doi: 10.1016/0029-7844(95)00097-B.
    1. Honest H, et al. Screening to prevent spontaneous preterm birth: systemtic reviews of accuracy and effectiveness literature with economic modelling. Health Technol Assess. 2009;13(43):1–627. doi: 10.3310/hta13430.
    1. Kass EH. The role of asymptomatic bacteriuria in the pathogenesis of pyelonephritis. In: Quinn EL, Kass EH (eds) Biology of pyelonephritis. In: Quinn EL, Kass EH, editors. Biology of pyelonephritis. Boston: Little, Brown and Co.; 1960. pp. 399–412.
    1. Millar L. Rapid enzymatic urine screening test to detect bacteriuria in pregnancy. Obstet Gynecol. 2000;95:601.
    1. McNair RD. Evaluation of the centrifuged and Gram-steined smear, urinalysis and reagent strip testing to detect asymptomatic bacteriuria in obstetric patients. Am J Obstet Gynecol. 2000;182:1076. doi: 10.1067/mob.2000.105440.
    1. Shelton SD. Urinary interleukin-8 with asymptomatuc bacteriuria in pregnancy. Obstet Gynecol. 2001;97:583.
    1. Hooton TM. A prospective study of asymptomatic bacteriuria in sexually active young women. N Engl J Med. 2000;343(14):992. doi: 10.1056/NEJM200010053431402.
    1. Lin K, Fajardo K. U.S. Preventive Services Task Force. Screening for asymptomatic bacteriuria in adults. Ann Intern Med. 2008;149:W20. doi: 10.7326/0003-4819-149-1-200807010-00009-w1.
    1. Nicolle LE, Bradley S, Colgan R, et al. IDSA guideline for the diagnosis and treatment of asymptomatic bacteriuria in adults. Clin Infect Dis. 2005;40:643–654. doi: 10.1086/427507.
    1. Lucas MJ, Cunningham FG. Urinary infection in pregnancy. Clin Obstet Gynecol. 1993;36(4):855–868. doi: 10.1097/00003081-199312000-00009.
    1. Cabiddu F, Castellino S, Daidone G, et al. Linee-guida Rene e Gravidanza. G. Ital. Nefrol. 2000;17:24–46.
    1. Widmer M, Gülmezoglu AM, Mignini L, Roganti A (2011) Duration of treatment for asymptomatic bacteriuria during pregnancy. Cochrane Database Syst Rev. 12:CD000491. doi:10.1002/14651858.CD000491.pub2
    1. Lumbiganon P, Laopaiboon M, Thinkhamrop J. Screening and treating asymptomatic bacteriuria in pregnancy. Curr Opin Obstet Gynecol. 2010;22(2):95–99. doi: 10.1097/GCO.0b013e3283374adf.
    1. Estebanez A, Pascual R, Gil V, Ortiz F, Santibáñez M, Pérez Barba C. Fosfomycin in a single dose versus a 7-day course of amoxicillin-clavulanate for the treatment of asymptomatic bacteriuria during pregnancy. Eur J Clin Microbiol Infect Dis. 2009;28(12):1457–1464. doi: 10.1007/s10096-009-0805-6.
    1. Keating GM. Fosfomycin trometamol: a review of its use as a single-dose oral treatment for patients with acute lower urinary tract infections and pregnant women with asymptomatic bacteriuria. Drugs. 2013;73(17):1951–1966. doi: 10.1007/s40265-013-0143-y.
    1. Usta TA, Dogan O, Ates U, Yucel B, Onar Z, Kaya E. Comparison of single-dose and multiple-dose antibiotics for lower urinary tract infection in pregnancy. Int J Gynaecol Obstet. 2011;114(3):229–233. doi: 10.1016/j.ijgo.2011.03.014.
    1. Schito GC, Naber KG, Botto H, Palou J, Mazzei T, Gualco L, Marchese A. The ARESC study: an international survey on the antimicrobial resistance of pathogens involved in uncomplicated urinary tract infections. Int J Antimicrob Agents. 2009;34(5):407–413. doi: 10.1016/j.ijantimicag.2009.04.012.
    1. Rodríguez-Baño J, Alcalá JC, Cisneros JM, et al. Community infections caused by extended-spectrum beta-lactamase-producing E. coli. Arch Intern Med. 2008;168(17):1897–1902. doi: 10.1001/archinte.168.17.1897.
    1. Andersen JT. Clarithromycin in early pregnancy and the risk of miscarriage and malformation: a register based nationwide cohort study. PLoS One. 2013;8(1):e53327. doi: 10.1371/journal.pone.0053327.
    1. Stein GE. Single-dose treatment of acute cystitis with fosfomycin tromethamine. Ann Pharmacother. 1998;32:215. doi: 10.1345/aph.17227.
    1. Crider KS. Antibacterial medication use during pregnancy and risk of birth defect: National Birth Defects Prevention Study. Arch Pediatr Adolesc Med. 2009;163(11):978. doi: 10.1001/archpediatrics.2009.188.
    1. American College of Obstetricians and Gynecologists Committee on Obstetric Practice ACOG Committee Opinion no 494. Obstet Gynecol. 2011;117(6):1484. doi: 10.1097/AOG.0b013e3182238c57.
    1. Nordeng H. Neonatal outcomes after gestational exposure to nitrofurantoin. Obstet Gynecol. 2013;121:306–313. doi: 10.1097/AOG.0b013e31827c5f88.
    1. Hernández-Díaz S, Werler MM, Walker AM, Mitchell AA. Folic acid antagonists during pregnancy and the risk of birth defects. N Engl J Med. 2000;343(22):1608–1614. doi: 10.1056/NEJM200011303432204.
    1. Bar-Oz B. The safety of quinolones—a meta-analysis of pregnancy outcome. Eur J Obstet Gynecol Reprod Biol. 2009;143(2):75–78. doi: 10.1016/j.ejogrb.2008.12.007.
    1. Macejko AM, Schaeffer AJ. Asymptomatic bacteriuria and symptomtic urinary tract infections during pregnancy. Urol Clin North Am. 2007;34:35–42. doi: 10.1016/j.ucl.2006.10.010.
    1. Hill JB, Sheffield JS, McIntire DD, Wendel GD., Jr Acute pyelonephritis in pregnancy. Obstet Gynecol. 2005;105(1):18–23. doi: 10.1097/01.AOG.0000149154.96285.a0.
    1. Wing DA, Fassett MJ, Getahun D (2014) Acute pyelonephritis in pregnancy: an 18-year retrospective analysis. Am J Obstet Gynecol 210(3):219.e1-6
    1. Artero A, Alberola J, Eiros JM, Nogueira JM, Cano A. Pyelonephritis in pregnancy. How adequate is empirical treatment? Rev Esp Quimioter. 2013;26(1):30–33.
    1. Minassian C, Thomas SL, Williams DJ, Campbell O, Smeeth L. Acute maternal infection and risk of pre-eclampsia: a population-based case-control study. PLoS One. 2013;8(9):e73047. doi: 10.1371/journal.pone.0073047.
    1. Riley JM, Dudley AG, Semins MJ. Nephrolithiasis and pregnancy: has the incidence been rising? Endourol. 2014;28(3):383–386. doi: 10.1089/end.2013.0570.
    1. Ross AE, Handa S, Lingeman JE, Matlaga BR. Kidney stones during pregnancy: an investigation into stone composition. Urol Res. 2008;36(2):99. doi: 10.1007/s00240-008-0138-4.
    1. Smith CL, Kristensen C, Davis M, Abraham PA. An evaluation of the physicochemical risk for renal stone disease during pregnancy. Clin Nephrol. 2001;55(3):205–211.
    1. Butler EL, Cox SM, Cunningham FG. Symptomatic nephrolithiasis complicating pregnancy. Obstet Gynecol. 2000;96:573.
    1. McAleer SJ, Loughlin KR. Nephrolithiasis and pregnancy. Curr Opin Urol. 2004;14:123. doi: 10.1097/00042307-200403000-00013.
    1. Elgamasy A, Elsherif A. Use of Doppler ultrasonography and rigid ureteroscopy for managing symptomatic ureteric stones during pregnancy. BJU Int. 2010;106:262. doi: 10.1111/j.1464-410X.2009.08950.x.
    1. Fulgham PF, Assimos DG, Pearle MS, Preminger GM. Clinical effectiveness protocols for imaging in the management of ureteral calculous disease: AUA technology assessment. J Urol. 2013;189:1203. doi: 10.1016/j.juro.2012.10.031.
    1. Semins MJ, Trock BJ, Matlaga BR. The safety of ureteroscopy during pregnancy: a systematic review and meta-analysis. J Urol. 2009;181:139. doi: 10.1016/j.juro.2008.09.029.
    1. Watterson JD, Girvan AR, Beiko DT, et al. Ureteroscopy and holmium: YAG laser lithotripsy: an emerging definitive management strategy for symptomatic ureteral calculi in pregnancy. Urology. 2002;60:383. doi: 10.1016/S0090-4295(02)01751-X.
    1. Adanur S, Ziypak T, Bedir F, et al. Ureteroscopy and holmium laser lithotripsy: is this procedure safe in pregnant women with ureteral stones at different locations? Arch Ital Urol Androl. 2014;86(2):86–89. doi: 10.4081/aiua.2014.2.86.
    1. Piccoli GB, Attini R, Parisi S, et al. Excessive urinary tract dilatation and proteinuria in pregnancy: a common and overlooked association? BMC Nephrol. 2013;27(14):52. doi: 10.1186/1471-2369-14-52.
    1. Piccoli GB, Attini R, De Pascale A, et al. Protean presentation and multiple challenges of nephrocalcinosis in pregnancy (six pregnancies in four patients) Nephrol Dial Transplant. 2012;27(3):1131–1138. doi: 10.1093/ndt/gfr390.
    1. Lewis DF, Robichaux AG, Jaekle RK, et al. Urolithiasis in pregnancy. Diagnosis, management and pregnancy outcome. J Reprod Med. 2003;48:28–32.
    1. Swartz MA, Lydon-Rochelle MT, Simon D, et al. Admission for nephrolithiasis in pregnancy and risk of adverse birth outcomes. Obstet Gynecol. 2007;109:1099. doi: 10.1097/01.AOG.0000259941.90919.c0.
    1. Rosenberg E, Sergienko R, Abu-Ghanem S, et al. Nephrolithiasis during pregnancy: characteristics, complications, and pregnancy outcome. World J Urol. 2011;29:743–747. doi: 10.1007/s00345-011-0719-7.
    1. Banhidy F, Acs N, Puho EH, et al. Maternal kidney stones during pregnancy and adverse birth outcomes, particularly congenital abnormalities in the offspring. Arch Gynecol Obstet. 2007;275:481–487. doi: 10.1007/s00404-006-0277-1.
    1. Jungers P, Houillier P, Chauveau D, et al. Pregnancy in women with reflux nephropathy. Kidney Int. 1996;50(2):593–599. doi: 10.1038/ki.1996.354.
    1. North RA, Taylor RS, Gunn TR. Pregnancy outcome in women with reflux nephropathy and the inheritance of vesico-ureteric reflux. Aust N Z J Obstet Gynaecol. 2000;40(3):280–285. doi: 10.1111/j.1479-828X.2000.tb03335.x.
    1. . Accessed 20 June 2014
    1. Kidney Disease: Improving Global Outcomes (KDIGO) Transplant Work Group KDIGO clinical practice guideline for the care of kidney transplant recipients. Am J Transplant. 2009;9(Suppl 3):S1–S155.
    1. EBPG Expert Group on Renal Transplantation European best practice guidelines for renal transplantation. Section IV: long-term management of the transplant recipient. IV.10. Pregnancy in renal transplant recipients. Nephrol Dial Transplant. 2002;17(Suppl 4):50–55.
    1. Østensen M, Khamashta M, Lockshin M, et al. Anti-inflammatory and immunosuppressive drugs and reproduction. Arthritis Res Ther. 2006;8:209. doi: 10.1186/ar1957.
    1. Bar Oz B, Hackman R, Einarson T, Koren G. Pregnancy outcome after cyclosporine therapy during pregnancy: a meta-analysis. Transplantation. 2001;71:1051–1055. doi: 10.1097/00007890-200104270-00006.
    1. Kainz A, Harabacz I, Cowlrick IS, et al. Review of the course and outcome of 100 pregnancies in 84 women treated with tacrolimus. Transplantation. 2000;70:1718–1721. doi: 10.1097/00007890-200012270-00010.
    1. Park-Wyllie L, Mazzotta P, Pastuszak A, et al. Birth defects after maternal exposure to corticosteroids: prospective cohort study and meta-analysis of epidemiological studies. Teratology. 2000;62:385–392. doi: 10.1002/1096-9926(200012)62:6<385::AID-TERA5>;2-Z.
    1. Sifontis NM, Coscia LA, Constantinescu S, et al. Pregnancy outcomes in solid organ transplant recipients with exposure to mycophenolate mofetil or sirolimus. Transplantation. 2006;82:1698–1702. doi: 10.1097/01.tp.0000252683.74584.29.
    1. Anderka MT, Lin AE, Abuelo DN, et al. Reviewing the evidence for mycophenolate mofetil as a new teratogen: case report and review of the literature. Am J Med Genet A. 2009;149:1241–1248. doi: 10.1002/ajmg.a.32685.
    1. Framarino-dei-Malatesta M, Derme M, Manzia TM, et al. Impact of mTOR-I on fertility and pregnancy: state of the art and review of the literature. Expert Rev Clin Immunol. 2013;9:781–789. doi: 10.1586/1744666X.2013.824243.
    1. Stokholm J, Schjørring S, Pedersen L, et al. Prevalence and predictors of antibiotic administration during pregnancy and birth. PLoS One. 2013;8(12):e82932. doi: 10.1371/journal.pone.0082932.
    1. Martinez de Tejada B. Antibiotic use and misuse during pregnancy and delivery: benefits and risks. Int J Environ Res Public Health. 2014;11(8):7993–8009. doi: 10.3390/ijerph110807993.
    1. Thinkhamrop J, Hofmeyr GJ, Adetoro O, Lumbiganon P, Ota E (2015) Antibiotic prophylaxis during the second and third trimester to reduce adverse pregnancy outcomes and morbidity. Cochrane Database Syst Rev 6:CD002250
    1. Nahum GG, Uhl K, Kennedy DL. Antibiotic use in pregnancy and lactation: what is and is not known about teratogenic and toxic risks. Obstet Gynecol. 2006;107(5):1120–1138. doi: 10.1097/01.AOG.0000216197.26783.b5.
    1. Matuszkiewicz-Rowińska J, Małyszko J, Wieliczko M. Urinary tract infections in pregnancy: old and new unresolved diagnostic and therapeutic problems. Arch Med Sci. 2015;11(1):67–77. doi: 10.5114/aoms.2013.39202.
    1. Grandone E, Villani M, Tiscia GL. Aspirin and heparin in pregnancy. Expert Opin Pharmacother. 2015;16(12):1793–1803. doi: 10.1517/14656566.2015.1066335.
    1. Guyatt GH, Akl EA, Crowther M, et al. Executive summary: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141(2 Suppl):7–47. doi: 10.1378/chest.1412S3.
    1. Reisenberger K, Egarter C, Kapiotis S, et al. Transfer of erythropoietin across the placenta perfused in vitro. Obstet Gynecol. 1997;89(5 Pt 1):738–742. doi: 10.1016/S0029-7844(97)00097-5.
    1. Krafft A, Bencaiova G, Breymann C. Selective use of recombinant human erythropoietin in pregnant patients with severe anemia or nonresponsive to iron sucrose alone. Fetal Diagn Ther. 2009;25(2):239–245. doi: 10.1159/000223441.
    1. Torrance HL, Benders MJ, Derks JB, et al. Maternal allopurinol during fetal hypoxia lowers cord blood levels of the brain injury marker S-100B. Pediatrics. 2009;124(1):350–357. doi: 10.1542/peds.2008-2228.
    1. Hoeltzenbein M, Stieler K, Panse M, et al. Allopurinol use during pregnancy—outcome of 31 prospectively ascertained cases and a phenotype possibly indicative for teratogenicity. PLoS One. 2013;8(6):e66637. doi: 10.1371/journal.pone.0066637.
    1. De-Regil LM, Palacios C, Ansary A et al (2012) Vitamin D supplementation for women during pregnancy. Cochrane Database Syst Rev 2:CD008873
    1. Lawlor DA, Wills AK, Fraser A, et al. Association of maternal vitamin D status during pregnancy with bone-mineral content in offspring: a prospective cohort study. Lancet. 2013;381:2176. doi: 10.1016/S0140-6736(12)62203-X.
    1. IOM (Institute of Medicine) Dietary reference intakes for calcium and vitamin D. Washington: The National Academies Press; 2011.
    1. Misra M, Pacaud D, Petryk A, et al. Vitamin D deficiency in children and its management: review of current knowledge and recommendations. Pediatrics. 2008;122(2):398–417. doi: 10.1542/peds.2007-1894.
    1. Wagner CL, Greer FR, The Section on Breastfeeding and Committee on Nutrition Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. Pediatrics. 2008;122(5):1142–1152. doi: 10.1542/peds.2008-1862.
    1. ACOG Committee on Obstetric Practice ACOG Committee Opinion No. 495: vitamin D: screening and supplementation during pregnancy. Obstet Gynecol. 2011;118(1):197–198. doi: 10.1097/AOG.0b013e318227f06b.
    1. Holick MF, Binkley NC, Bischoff-Ferrari HA et al. (2011) Endocrine Society. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline (published correction appears in J Clin Endocrinol Metab 2011;96(12):3908). J Clin Endocrinol Metab. 2011;96(7):1911–1930
    1. Piccoli GB, Cabiddu G, Attini R, et al. Pregnancy in chronic kidney disease: questions and answers in a changing panorama. Best Pract Res Clin Obstet Gynaecol. 2015;29(5):625–642. doi: 10.1016/j.bpobgyn.2015.02.005.
    1. Chakravarty EF, Murray ER, Kelman A, Farmer P. Pregnancy outcomes after maternal exposure to rituximab. Blood. 2011;117(5):1499–1506. doi: 10.1182/blood-2010-07-295444.
    1. Klink DT, van Elburg RM, Schreurs MW, van Well GT. Rituximab administration in third trimester of pregnancy suppresses neonatal B-cell development. Clin Dev Immunol. 2008;2008:271363. doi: 10.1155/2008/271363.

Source: PubMed

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