Kidney disease increases the risk of preterm birth, neonatal ICU admission and infant death, according to a study presented in the July issue of the National Kidney Foundation’s American Journal of Kidney Diseases. The retrospective study is the first of its kind to isolate the pregnancy risks related directly to kidney disease.
Subjects for the study were gathered from an integrated health care database covering pregnant women in Utah and Idaho between 2000 and 2013. There were 778 women who met the criteria for kidney disease stages 3-5 prior to conception or within their first trimester. The women were matched to a control group of women with similar physical and lifestyle traits, the only difference being the control group did not have kidney disease.
Researchers found those with kidney disease had 52% increased odds of preterm delivery and a ten-fold increase in premature births of less than 20 weeks. Women also had 33% increased odds of delivery by cesarean section. Infants born to women with kidney disease had 71% higher odds of the combined outcome of admission to the neonatal intensive care unit or infant death compared with those born to women without kidney disease. Kidney disease also was associated with 2-fold increased odds of low birth weight.
Researchers did not find any correlation between kidney disease and increased risk of maternal death.
It is estimated that 3% of all women of child-bearing age have chronic kidney disease. The study will help inform women and health care professionals, about the risks inherent in pregnancy with kidney disease.
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“Based on this research, providers should focus on preconception counseling for women with kidney disease,” said lead researcher, Jessica Kendrick, MD, an Associate Professor at the University of Colorado Anschutz Medical Campus. “Despite advances in medicine, women with kidney disease are more likely to have adverse pregnancy outcomes. This creates an opportunity to find interventions that can help us decrease adverse pregnancy events in the future.”