- Women who experience adverse pregnancy outcomes, including hypertensive disorders of pregnancy (HDP), gestational diabetes and pre-term delivery, may be at an increased risk for future chronic kidney disease (CKD) and end-stage kidney disease (ESKD).
- ESKD risk was highest among women who experienced preeclampsia.
Why this matters
- Women with HDP and other adverse pregnancy outcomes may warrant closer surveillance for long-term kidney disease.
- 23 studies (n=5,769,891) met eligibility criteria after a search across PubMed, Embase, and Web of Science.
- Primary outcomes: CKD and ESKD diagnosis.
- Funding: The Wellcome Trust and the Health Research Board and others.
- Pre-eclampsia was associated with a significantly increased risk for:
- CKD (adjusted risk ratio [aRR], 2.11; 95% CI, 1.72-2.59);
- ESKD (aRR, 4.90; 95% CI, 3.56-6.74; I2=73%); and
- kidney-related hospitalisation (aRR, 2.65; 95% CI, 1.03-6.77; I2=92%).
- Women with gestational hypertension were at an increased risk for:
- CKD (aRR, 1.49; 95% CI, 1.11-2.01) and
- ESKD (aRR, 3.64; 95% CI, 2.34-5.66).
- Pre-term pre-eclampsia was associated with an increased risk for ESKD (aRR, 5.66; 95% CI, 3.06-10.48; I2=59%).
- Women with pre-term deliveries, without pre-eclampsia, were at a higher risk for ESKD (aRR, 2.09; 95% CI, 1.64-2.66).
- Gestational diabetes tied to an increased risk for CKD in black women (aRR, 1.78; 95% CI, 1.18-2.70) but not in white women (aRR, 0.81; 95% CI, 0.58-1.13).
- Heterogeneity among studies.