Abstract
Objective
To investigate whether patients with a history of intrauterine fetal death (IUFD) have an increased risk for subsequent maternal long-term renal morbidity.
Study Design
A population-based study compared the incidence of long-term maternal renal morbidity in a cohort of women with and without a history of IUFD. Deliveries occurred during a 25 years period in a tertiary medical center. Mean follow-up duration of 11.2 years. Renal morbidity included kidney transplantation, chronic renal failure, hypertensive renal disease etc. Patients with known renal malformation or known renal disease prior to pregnancy were excluded from the study. Kaplan-Meier survival curves were used to estimate cumulative incidence of renal related hospitalizations. Cox proportional hazards models were used to estimate the adjusted hazard ratios (HR) for renal related hospitalizations.
Results
During the study period 99,351 parturient met the inclusion criteria; 1.9% (n=1877) occurred in patients who were diagnosed at least once with IUFD. During the follow-up period patients with IUFD had significantly higher rate of renal morbidity (0.4% vs. 0.1%; odds ratio 3.1; 95% confidence interval 1.4-6.6; P=0.001). Using a Kaplan-Meier survival curve, patients with a previous diagnosis of IUFD had a significantly higher cumulative incidence of renal related hospitalizations (Figure). When performing a Cox proportional hazards model, adjusted for confounders such as preeclampsia and diabetes mellitus, a history of IUFD remained independently associated with renal related hospitalizations (Table).
Conclusion
Intrauterine fetal death is an independent risk factor for long term maternal renal complications.
To investigate whether patients with a history of intrauterine fetal death (IUFD) have an increased risk for subsequent maternal long-term renal morbidity.
Study Design
A population-based study compared the incidence of long-term maternal renal morbidity in a cohort of women with and without a history of IUFD. Deliveries occurred during a 25 years period in a tertiary medical center. Mean follow-up duration of 11.2 years. Renal morbidity included kidney transplantation, chronic renal failure, hypertensive renal disease etc. Patients with known renal malformation or known renal disease prior to pregnancy were excluded from the study. Kaplan-Meier survival curves were used to estimate cumulative incidence of renal related hospitalizations. Cox proportional hazards models were used to estimate the adjusted hazard ratios (HR) for renal related hospitalizations.
Results
During the study period 99,351 parturient met the inclusion criteria; 1.9% (n=1877) occurred in patients who were diagnosed at least once with IUFD. During the follow-up period patients with IUFD had significantly higher rate of renal morbidity (0.4% vs. 0.1%; odds ratio 3.1; 95% confidence interval 1.4-6.6; P=0.001). Using a Kaplan-Meier survival curve, patients with a previous diagnosis of IUFD had a significantly higher cumulative incidence of renal related hospitalizations (Figure). When performing a Cox proportional hazards model, adjusted for confounders such as preeclampsia and diabetes mellitus, a history of IUFD remained independently associated with renal related hospitalizations (Table).
Conclusion
Intrauterine fetal death is an independent risk factor for long term maternal renal complications.
| Original language | English |
|---|---|
| Pages (from-to) | S280-S281 |
| Journal | American Journal of Obstetrics and Gynecology |
| Volume | 210 |
| DOIs | |
| State | Published - 31 Jan 2014 |
