330: Renal function in the low quartiles of the normal range during pregnancy is associated with an increased risk for long-term maternal atherosclerotic morbidity

Objective
To examine the association between renal function (createnine and urea) during pregnancy and the development of future long-term maternal atherosclerotic morbidity (including cardiovascular, cerebrovascular and renal disease).
Study Design
A case-control study was conducted including women who delivered between the years 2000-2012 and subsequently develop atherosclerotic morbidity (n=661); controls were matched for age and year of delivery (n=4373). The mean follow-up duration was 74 months. The hospitalized group was further divided to major event (cardiovascular, cerebrovascular disease, chronic renal failure), and cardiac procedures (such as coronary angiography). Kaplan-Meier survival curves were used to estimate cumulative incidence of atherosclerotic hospitalizations . Cox proportional hazards models were used to estimate the adjusted hazard ratios (HR) for hospitalizations.

Results
A significant linear association was documented between createnine and urea during pregnancy and long-term maternal atherosclerotic morbidity (Table). Using Kaplan-Meier survival curves, createnine (Figure 1A) and urea (Figure 1B) levels in the high quartiles of the normal range had a significant higher cumulative incidence of atherosclerotic hospitalizations . Cox proportional hazard models, adjusted for confounders such as preeclampsia, diabetes mellitus, and obesity, showed that both, high createnine and urea levels during pregnancy, remained independently associated with atherosclerotic hospitalizations (adjusted HR=1.38, 95% CI 1.17-1.61, P<0.001 and adjusted HR=1.42, 95% CI 1.23-1.65, P<0.001; respectively ).
Conclusion
Createnine and urea levels at the higher normal range during pregnancy may predict maternal atherosclerotic morbidity later in non-pregnant life.