Abstract
Objective
The prevalence of chronic kidney disease (CKD) appear to be increasing globally; it is higher in females, increases with age and is the highest in patients with diabetes mellitus. Delivery of a small for gestational age (SGA) neonate was recently noted as a risk factor for long-term maternal cardiovascular events. The present study was aimed to investigate whether delivery of an SGA neonate poses a risk for subsequent long-term maternal CKD.
Study Design
A population-based study compared the incidence of long-term renal morbidity in a cohort of women with and without a previous delivery of an SGA neonate. Deliveries occurred during 25 years period, with a mean follow-up duration of 11.2 years. Renal morbidity included chronic renal failure, hypertensive renal disease etc. Patients with known renal disease before the index pregnancy were excluded from the study. Cox proportional hazards model was used to estimate the adjusted hazards ratio (HR) for CKD.
Results
Out of 99342 deliveries that met the inclusion criteria, 10701 (10.7%) occurred in patients who had at least one previous delivery of an SGA neonate. During the follow-up period, patients with a delivery of SGA neonate had higher rates of renal-related hospitalizations (0.2% vs. 0.1 %; OR=1.6, 95% CI 1.01-2.5; P= 0.04, Table). In a Cox proportional hazards model, adjusting for confounders such as parity and diabetes mellitus, previous delivery of an SGA neonate was independently associated with maternal CKD (adjusted HR, 1.7; 95% CI 1.1-2.8).
Conclusion
Delivery of an SGA neonate is an independent risk factor for long-term maternal chronic kidney disease.
The prevalence of chronic kidney disease (CKD) appear to be increasing globally; it is higher in females, increases with age and is the highest in patients with diabetes mellitus. Delivery of a small for gestational age (SGA) neonate was recently noted as a risk factor for long-term maternal cardiovascular events. The present study was aimed to investigate whether delivery of an SGA neonate poses a risk for subsequent long-term maternal CKD.
Study Design
A population-based study compared the incidence of long-term renal morbidity in a cohort of women with and without a previous delivery of an SGA neonate. Deliveries occurred during 25 years period, with a mean follow-up duration of 11.2 years. Renal morbidity included chronic renal failure, hypertensive renal disease etc. Patients with known renal disease before the index pregnancy were excluded from the study. Cox proportional hazards model was used to estimate the adjusted hazards ratio (HR) for CKD.
Results
Out of 99342 deliveries that met the inclusion criteria, 10701 (10.7%) occurred in patients who had at least one previous delivery of an SGA neonate. During the follow-up period, patients with a delivery of SGA neonate had higher rates of renal-related hospitalizations (0.2% vs. 0.1 %; OR=1.6, 95% CI 1.01-2.5; P= 0.04, Table). In a Cox proportional hazards model, adjusting for confounders such as parity and diabetes mellitus, previous delivery of an SGA neonate was independently associated with maternal CKD (adjusted HR, 1.7; 95% CI 1.1-2.8).
Conclusion
Delivery of an SGA neonate is an independent risk factor for long-term maternal chronic kidney disease.
| Original language | English |
|---|---|
| Pages (from-to) | S387-S387 |
| Journal | American Journal of Obstetrics and Gynecology |
| Volume | 212 |
| Issue number | 1 |
| DOIs | |
| State | Published - Jan 2015 |
