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To evaluate the status of kidney disease, clinical data from mothers with Alport syndrome in China and Europe over the pregnancy were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective observational study collected data to evaluate proteinuria, kidney function and Alport stage prior to, during, and after pregnancy, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 74 women were enrolled, 82% of them with X-linked Alport syndrome and 11% with autosomal Alport syndrome (unknown in 5 patients). Detailed information on the course of pregnancy was available for 62 pregnancies from 52 different women.\u00a0No fetal malformations were observed. Mean gestational age was 37.9\u2009\u00b1\u20092.7\u00a0weeks (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200955).\ufeff\u00a0Complications included high blood pressure (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20098), abortion (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20095), preeclampsia (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20095), gestational diabetes (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20093), nephrotic syndrome (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092), cervical insufficiency with fetal growth delay (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20092), premature rupture of membranes (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091) and acute intrauterine fetal distress (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091).\u00a0Median proteinuria was 350 (30\u20132465) mg\/day prior to pregnancy, 2390 (450\u201311,450) mg\/day during pregnancy, and 590 (40\u20132650) mg\/day at a mean postpartum follow-up time of 4.5\u2009\u00b1\u20092.1\u00a0years. Mean estimated glomerular filtration rate (eGFR) decreased by 17.2\u2009\u00b1\u200916.7\u00a0ml\/min\/1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      , from 96.1\u2009\u00b1\u200932.9 to 78.9\u2009\u00b1\u200937\u00a0ml\/min\/1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      after pregnancy (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200915;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003). The eGFR loss was higher in women with eGFR\u2009&lt;\u200990\u00a0ml\/min\/1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      prior to pregnancy compared to women with normal renal function (\u2013\u00a021.5\u2009\u00b1\u20099.8 vs. \u2013\u00a014\u2009\u00b1\u200920\u00a0ml\/min\/1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      ), and in women with severe variants compared to women with less severe variants (\u2013\u00a021.5\u2009\u00b1\u200920.2 vs. \u2013\u00a011.3\u2009\u00b1\u200919.0\u00a0ml\/min\/1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      ). Progression of Alport stage after pregnancy was observed in 42% of the women, 31% remained in stage 0-1, and 23% remained in stage 2.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      This study provides important data on the natural history of Alport syndrome in women who have undergone\u00a0 a pregnancy. Women with severe variants of Alport syndrome, and women with eGFR below 90\u00a0ml\/min\/1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      face greater risks of kidney disease progression after pregnancy. Further prospective studies are required to confirm these findings.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1007\/s40620-025-02252-2","type":"journal-article","created":{"date-parts":[[2025,5,20]],"date-time":"2025-05-20T11:26:42Z","timestamp":1747740402000},"page":"1085-1092","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A retrospective study of kidney disease in Alport syndrome during and after pregnancy"],"prefix":"10.1093","volume":"38","author":[{"given":"Xinxin","family":"Kong","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Boeckhaus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunyan","family":"Shi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongwen","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"Gross","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Ding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanqin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,5,20]]},"reference":[{"issue":"5","key":"2252_CR1","doi-asserted-by":"publisher","first-page":"844","DOI":"10.2215\/CJN.07911109","volume":"5","author":"GB Piccoli","year":"2010","unstructured":"Piccoli GB, Attini R, Vasario E et al (2010) Pregnancy and chronic kidney disease. 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Data acquisition in China was reviewed and approved by the Institutional Review Board of Peking University First Hospital (2022 [051] V1.0). Informed consent for this study was obtained from all patients. Data acquisition in Europe was part of the European Alport registry, which has been reviewed and approved by the Institutional Review Board of University Medicine Goettingen (AZ 10\/11\/06).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"All procedures were approved by the Peking University First Hospital Institutional Review Board (2022 [051] V1.0) and the University Medicine Goettingen Institutional Review Board (AZ 10\/11\/06).","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Statement of human and animal rights"}},{"value":"Informed consent was obtained from all individual participants.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}