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Abstract: PO2597

Pregnancy Outcomes in Women with AKI

Session Information

Category: Women’s Health and Kidney Diseases

  • 2000 Women’s Health and Kidney Diseases

Authors

  • Shah, Silvi, University of Cincinnati, Cincinnati, Ohio, United States
  • Harrison, Kathleen, University of Cincinnati, Cincinnati, Ohio, United States
  • Christianson, Annette, University of Cincinnati, Cincinnati, Ohio, United States
Background

Acute kidney injury (AKI) during pregnancy is a public health problem and is associated with maternal and fetal morbidity and mortality. Literature concerning pregnancy outcomes in women with AKI is scarce.

Methods

We evaluated a retrospective single-center cohort of all women who delivered infants between 2012-2019 at our center (N=21,038) to assess the AKI rate and whether the history of AKI during pregnancy was associated with adverse maternal and fetal outcomes. Using multivariate logistic regression models, we determined factors associated with AKI, and associations between AKI and pregnancy outcomes.

Results

Overall, 109 deliveries were identified with AKI during pregnancy. AKI rate was 0.5%. The mean age of women was 28 years, 55% were black, and 36% were white. 25% had a history of diabetes and 24% had a history of hypertension. With regards to maternal outcomes, 46% had preeclampsia, 27% had gestational diabetes, 40% had gestational hypertension, and 57% had cesarean section deliveries. Maternal mortality was 4%. With regards to fetal outcomes, among women with AKI during pregnancy, 19% had preterm deliveries, the live birth rate was 85%, the stillbirth rate was 5%, and neonatal mortality was 5%. Diabetes and hypertension were associated with a higher adjusted likelihood of AKI during pregnancy (OR, 4.59; 95% CI, 2.87-7.50 and OR, 5.97; 95% CI, 3.63-9.80 respectively). In the adjusted model, AKI during pregnancy was associated with a 5.6-fold higher likelihood of preeclampsia (OR, 5.57; 95% CI, 3.70-8.39), 2.2-fold higher likelihood of cesarean section (OR, 2.21; 95% CI, 1.50-3.27), 2-fold higher likelihood of preterm births (OR, 1.97; 95% CI, 1.22-3.16), 4-fold higher likelihood of stillbirths (OR, 4.04; 95% CI, 1.60-10.20), and a 5.7-fold higher likelihood of neonatal mortality (OR, 5.65; 95% CI, 2.20-14.49).

Conclusion

AKI rate during pregnancy is 0.5%. AKI during pregnancy is associated with a higher likelihood of preeclampsia, preterm births, stillbirths, and neonatal mortality. This study increases our understanding and need for change in policies for the management of AKI during pregnancy.

Funding

  • Private Foundation Support