{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T20:02:29Z","timestamp":1791662549444,"version":"4.3.4"},"reference-count":48,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,3,15]],"date-time":"2024-03-15T00:00:00Z","timestamp":1710460800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Chronic kidney disease (CKD) is associated with an increased risk of adverse pregnancy outcomes, but the risk at different stages of CKD (defined by estimated glomerular filtration rate, eGFR) compared with women without CKD has not been quantified in large cohorts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To quantify the association between CKD and adverse pregnancy outcomes according to CKD definition, CKD stage and presence or absence of diabetes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Search strategy<\/jats:title><jats:p>A systematic search of EMBASE and MEDLINE from inception to 5 January 2023.<\/jats:p><\/jats:sec><jats:sec><jats:title>Selection criteria<\/jats:title><jats:p>English\u2010language randomised controlled trials as well as cohort and case\u2013control studies investigating adverse pregnancy outcomes in pregnant women with CKD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Data collection and analysis<\/jats:title><jats:p>Two reviewers conducted independent data extractions. A random\u2010effects model was used to estimate risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main results<\/jats:title><jats:p>We included 19 studies with 3\u2009251\u2009902 women. Defining CKD using eGFR or serum creatinine produced results with greater effect size but wider confidence intervals. Compared with CKD stages\u20091\u20132, women with CKD stages\u20093\u20135 have a greater risk, but also greater imprecision in the risk estimate, of the following outcomes: pre\u2010eclampsia (OR\u200955.18, 95%\u2009CI 2.63\u20131157.68, vs OR\u200924.74, 95%\u2009CI 1.75\u2013348.70), preterm birth (OR\u200920.24, 95%\u2009CI 2.85\u2013143.75, vs OR\u20098.18, 95%\u2009CI 1.54\u201343.46) and neonatal intensive care unit admission (OR\u200919.32, 95%\u2009CI 3.07\u2013121.68, vs OR\u20099.77, 95%\u2009CI 2.49\u201338.39). Women with diabetic kidney disease, compared with women without diabetic kidney disease, have higher risks of maternal mortality, small\u2010for\u2010gestational\u2010age neonates, pre\u2010eclampsia and gestational hypertension.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There is heterogeneity in the definition of CKD in pregnancy. Future studies should consider ways to standardise its definition and measurement in pregnancy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.17807","type":"journal-article","created":{"date-parts":[[2024,3,16]],"date-time":"2024-03-16T02:17:53Z","timestamp":1710555473000},"page":"1331-1340","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Adverse pregnancy outcomes in pregnant women with chronic kidney disease: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"131","author":[{"given":"Deepthika","family":"Jeyaraman","sequence":"first","affiliation":[{"name":"Academic Department of Obstetrics and Gynaecology University Hospital of North Midlands  Stoke\u2010on\u2010Trent UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben","family":"Walters","sequence":"additional","affiliation":[{"name":"Academic Department of Obstetrics and Gynaecology University Hospital of North Midlands  Stoke\u2010on\u2010Trent UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Bramham","sequence":"additional","affiliation":[{"name":"Department of Women and Children's Health King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Fish","sequence":"additional","affiliation":[{"name":"Department of Nephrology University Hospitals of North Midlands  Stoke\u2010on\u2010Trent UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Lambie","sequence":"additional","affiliation":[{"name":"Department of Nephrology University Hospitals of North Midlands  Stoke\u2010on\u2010Trent UK"},{"name":"School of Medicine Keele University  Keele Staffordshire UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0011-5636","authenticated-orcid":false,"given":"Pens\u00e9e","family":"Wu","sequence":"additional","affiliation":[{"name":"Academic Department of Obstetrics and Gynaecology University Hospital of North Midlands  Stoke\u2010on\u2010Trent UK"},{"name":"School of Medicine Keele University  Keele Staffordshire UK"},{"name":"Department of Obstetrics and Gynaecology, College of Medicine National Cheng Kung University  Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,3,15]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(20)30045\u20103"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kisu.2021.11.003"},{"issue":"2","key":"e_1_2_12_4_1","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1590\/2175-8239-jbn-2023-e008en","article-title":"Reproductive rights for women with chronic kidney disease. 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