Abstract: SA-OR025

Metabolic and Hypertensive Complications of Pregnancy in Women with Nephrolithiasis

Session Information

Category: Mineral Disease

  • 1204 Mineral Disease: Nephrolithiasis

Authors

  • Tangren, Jessica Sheehan, Massachusetts General Hospital, Boston, Massachusetts, United States
  • Ankers, Elizabeth D., Massachusetts General Hospital, Boston, Massachusetts, United States
  • Thadhani, Ravi I., Massachusetts General Hospital, Boston, Massachusetts, United States
Background

Kidney stones are associated with future development of hypertension, diabetes and the metabolic syndrome. The relationship between nephrolithiasis and pregnancy complications, including gestational dysglycemia and gestational hypertension has not previously been evaluated. We assessed whether stone formation prior to pregnancy was associated with metabolic and hypertensive complications in pregnancy. We hypothesized that stone formation is a marker of metabolic disease and associated with increased risk for maternal complications in pregnancy.

Methods

We conducted a retrospective cohort study of women who delivered infants at the Massachusetts General Hospital from 2006 to 2016. Women with abdominal imaging (CT or ultrasound) prior to pregnancy were included in the analysis. Pregnancy outcomes in women with documented stones on imaging (stone formers, n=174) were compared to women without stones on imaging (controls, n=1,330). Women with pre-existing CKD, hypertension and diabetes were excluded.

Results

Maximum systolic blood pressure (mSBP) in pregnancy was increased in stone formers versus controls despite similar first trimester blood pressure. Gestational diabetes and gestational hypertension were more common in stone formers (18% vs. 6%, p<0.01 and 19% vs. 13%, p=0.04). After multivariate adjustment, stones were associated with increased risk of preterm delivery, gestational diabetes and preeclampsia (1A). Stone formation was an effect modifier of the relationship between mSBP and BMI (1B).

Conclusion

In women without preexisting diabetes and hypertension, a history of nephrolithiasis was associated with gestational dysglycemia and hypertension. Nephrolithiasis may be a marker of increased metabolic risk in women without traditional risk factors for pregnancy complications.

Funding

  • Private Foundation Support