Abstract
Objective
To investigate whether preeclampsia poses a risk for subsequent long term maternal renal disease.
Study Design
A population-based study compared the incidence of long-term renal morbidity in a cohort of women with and without previous preeclampsia. Deliveries occurred during a 25 years period. Renal morbidity included kidney transplantation, chronic renal failure, hypertensive renal disease etc. Patients with multiple pregnancies, chronic hypertension and with known renal disease before the index pregnancy were excluded from the study. Kaplan-Meier survival curve was used to estimate cumulative incidence of renal hospitalizations. Cox proportional hazards model was used to estimate the adjusted hazards ratio (HR) for renal-related hospitalizations.
Results
Of 96430 women that met the inclusion criteria, 7828 (8.1%) occurred in patients who had at least one previous delivery with preeclampsia. Patients following preeclampsia had a significantly higher cumulative incidence of renal-related hospitalizations, using a Kaplan-Meier survival curve (Figure). During the follow-up period, patients with preeclampsia had higher rates of renal-related hospitalizations (0.3% vs. 0.1 %; OR=3.6, 95% CI 2.2-5.9; P<0.001). A significant linear association (using the chi-square test for trends) was found between the severity of preeclampsia and future risk for renal morbidity (Table). In a Cox proportional hazards model, adjusted for confounders such as parity and diabetes mellitus, previous preeclampsia was independently associated with maternal renal-related hospitalizations (adjusted HR, 3.6; 95% CI, 2.2-5.9).
Conclusion
Preeclampsia is an independent risk factor for long-term maternal renal disease. The risk is higher for patients with the severe forms of preeclampsia.
To investigate whether preeclampsia poses a risk for subsequent long term maternal renal disease.
Study Design
A population-based study compared the incidence of long-term renal morbidity in a cohort of women with and without previous preeclampsia. Deliveries occurred during a 25 years period. Renal morbidity included kidney transplantation, chronic renal failure, hypertensive renal disease etc. Patients with multiple pregnancies, chronic hypertension and with known renal disease before the index pregnancy were excluded from the study. Kaplan-Meier survival curve was used to estimate cumulative incidence of renal hospitalizations. Cox proportional hazards model was used to estimate the adjusted hazards ratio (HR) for renal-related hospitalizations.
Results
Of 96430 women that met the inclusion criteria, 7828 (8.1%) occurred in patients who had at least one previous delivery with preeclampsia. Patients following preeclampsia had a significantly higher cumulative incidence of renal-related hospitalizations, using a Kaplan-Meier survival curve (Figure). During the follow-up period, patients with preeclampsia had higher rates of renal-related hospitalizations (0.3% vs. 0.1 %; OR=3.6, 95% CI 2.2-5.9; P<0.001). A significant linear association (using the chi-square test for trends) was found between the severity of preeclampsia and future risk for renal morbidity (Table). In a Cox proportional hazards model, adjusted for confounders such as parity and diabetes mellitus, previous preeclampsia was independently associated with maternal renal-related hospitalizations (adjusted HR, 3.6; 95% CI, 2.2-5.9).
Conclusion
Preeclampsia is an independent risk factor for long-term maternal renal disease. The risk is higher for patients with the severe forms of preeclampsia.
| Original language | English |
|---|---|
| Pages (from-to) | S139 |
| Journal | American Journal of Obstetrics and Gynecology |
| Volume | 210 |
| Issue number | 1 |
| DOIs | |
| State | Published - 31 Jan 2014 |
