关键词: 抗中性粒细胞胞质抗体相关性肾炎, 抗髓过氧化酶-抗中性粒细胞胞质抗体, 妊娠结局, 胎儿

Abstract: Ｏｂｊｅｃｔｉｖｅ：To discuss the pregnancy outcomes and influence factors in patients with antineutrophil cytoplasmic antibody—associated glomerulonephritis (AAGN).
Ｍｅｔｈｏｄｏｌｏｇｙ：Five women with MPOANCA positive AAGN who achieved complete renal remission were collected in our unit. Prednisone or prednisone combined azathioprine (AZA) was administered during pregnancy. Vasculitis activity was scored by BVAS. Pregnancyrelated complications included relapse of AAGN, gestational hypertension, progression of chronic kidney disease (CKD), or acute kidney injury. Adverse fetal outcomes include premature delivery, fetal loss, and intrauterine growth retardation (IUGR).
Ｒｅｓｕｌｔｓ：We described 7 pregnancies in 5 patients who were all in remission at conception,and the mean time to renal remission was 32 months. EGFR of all the patients before pregnancy was more than 60 ml／(min·173m2), and proteinuria was less than 05 g／24h. Serum MPOANCA was positive in 4 pregnancies, and one with hypertension before pregnancy. Six pregnancies were maintained with prednisone monotherapy and one with prednisone combined AZA. 4 of the 7 pregnancies were no pregnancyrelated complications and the fetuses were delivered to term, and the other 3 pregnancies were with fetal or maternal complications (including one with severe hypertension in pregnancy and termination of pregnancy at 8 weeks, one with preeclampsia and fatal premature delivery, one experiencing a relapse during pregnancy with positive serum MPOANCA before pregnancy). The median followup after the last conception was 22 months, one patient experienced a relapse after conception, and the patient with hypertension before pregnancy progressed from CKD stage 1 to CKD stage 4.
Ｃｏｎｃｌｕｓｉｏｎ：Patients in remission of AAGN at conception can have a successful pregnancies, but MPOANCA positive increases the risk of recurrence, hypertension increases the risk of fetal adverse outcomes and the progression of CKD.

Key words: ANCA-associated glomerulonephritis, MPO-ANCA, pregnancy outcome fatal