Takeaway
- Women with a history of stillbirth were at an increased risk for chronic kidney disease (CKD) and end-stage renal disease (ESRD) compared with women who have only had live births.
- This association was independent of pre-eclampsia, small for gestational age (SGA), maternal smoking, obesity, and medical comorbidities.
Why this matters
- Findings suggest that women who experience stillbirth may warrant closer surveillance for postpartum hypertension and CKD.
Study design
- A population-based cohort study of 1,941,057 unique women who had 3,755,444 singleton pregnancies and followed up over 42,313,758 person-years.
- Funding: The Wellcome Trust and the Health Research Board and others.
Key results
- 13,032 (0.7%) women had ≥1 stillbirth, of which 11,841 (91%) were antepartum.
- Women who had experienced ≥1 stillbirth were at a higher risk of developing CKD (adjusted hazard ratio [aHR], 1.26; 95% CI, 1.09-1.45) and ESRD (aHR, 2.25; 95% CI, 1.55-3.25) compared with women who only had live births.
- The association between stillbirth and CKD was largely driven by antepartum stillbirths vs no stillbirth (aHR, 2.27; 95% CI, 1.54-3.35).
- The associations of stillbirth with CKD (aHR, 1.33; 95% CI, 1.13-1.57) and ESRD (aHR, 2.95; 95% CI, 1.86-4.68) were independent of pre-eclampsia, SGA or congenital malformations.
- No significant association observed between stillbirth and either CKD (aHR, 1.13; 95% CI, 0.73-1.75) or ESRD (aHR, 1.49; 95% CI, 0.78-2.85) in women who had pre-existing medical comorbidities.
Limitations
- Study did not conduct an analysis of recurrent stillbirth because of small numbers and paucity of the outcomes.
References
References
