Stillbirth is associated with increased risk of long-term maternal renal disease: a nationwide cohort study

Barrett, Peter; McCarthy, Fergus P.; Evans, Marie; Kublickas, Marius; Perry, Ivan J.; Stenvinkel, Peter; Khashan, Ali S.; Kublickiene, Karolina

doi:10.1016/j.ajog.2020.02.031

Cited by 13 publications

(22 citation statements)

References 37 publications

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“…We excluded multiple pregnancies ( n = 148,339) and pregnancies with implausible dates of delivery ( n = 312) from all analyses at baseline. We also excluded women who had stillbirths ( n = 14,107) to avoid potential confounding since they are more likely to experience preeclampsia compared with women who only have live births, and they are at increased risk of long-term CKD [ 21 ] ( S1 Fig ).…”

Section: Methodsmentioning

confidence: 99%

Hypertensive disorders of pregnancy and the risk of chronic kidney disease: A Swedish registry-based cohort study

et al. 2020

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Background Hypertensive disorders of pregnancy (HDP) (preeclampsia, gestational hypertension) are associated with an increased risk of end-stage kidney disease (ESKD). Evidence for associations between HDP and chronic kidney disease (CKD) is more limited and inconsistent. The underlying causes of CKD are wide-ranging, and HDP may have differential associations with various aetiologies of CKD. We aimed to measure associations between HDP and maternal CKD in women who have had at least one live birth and to identify whether the risk differs by CKD aetiology. Methods and findings Using data from the Swedish Medical Birth Register (MBR), singleton live births from 1973 to 2012 were identified and linked to data from the Swedish Renal Register (SRR) and National Patient Register (NPR; up to 2013). Preeclampsia was the main exposure of interest and was treated as a time-dependent variable. Gestational hypertension was also investigated as a secondary exposure. The primary outcome was maternal CKD, and this was classified into 5 subtypes: hypertensive, diabetic, glomerular/proteinuric, tubulointerstitial, and other/nonspecific CKD. Cox proportional hazard regression models were used, adjusting for maternal age, country of origin, education level, antenatal BMI, smoking during pregnancy, gestational diabetes, and parity. Women with pre-pregnancy comorbidities were excluded. The final sample consisted of 1,924,409 women who had 3,726,554 singleton live births. The mean (±SD) age of women at first delivery was 27.0 (±5.1) years. Median follow-up was 20.7 (interquartile range [IQR] 9.9-30.0) years. A total of 90,917 women (4.7%) were diagnosed with preeclampsia, 43,964 (2.3%) had gestational hypertension, and 18,477 (0.9%) developed CKD. Preeclampsia was associated with a higher risk of developing CKD during

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Section: Methodsmentioning

confidence: 99%

Hypertensive disorders of pregnancy and the risk of chronic kidney disease: A Swedish registry-based cohort study

et al. 2020

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“…The tool was developed after exhaustively reviewing relevant literature [13,16,20,[23][24][25][26][27][28]. A minor modification was made to suit the local context.…”

Section: Data Collection Tool and Proceduresmentioning

confidence: 99%

“…Previous researchers have revealed that asphyxia, maternal infection, non-communicable disease, chronic illness, resident, interpregnancy interval, previous preterm birth, premature rupture of membrane, the induced onset of labor, prolonged labor (>12 hours), multiple pregnancies, mode of delivery, maternal age, place of residence, education level, parity, antenatal care utilization, place of delivery, body mass index (BMI) and anemia, previous stillbirth, uterine rupture, abruption placentae, belonging to the poorest family, antepartum hemorrhage, maternal hypertensive disorder during pregnancy, and small weight-for gestational age babies are significant predictors of stillbirth [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29].…”

Section: Introductionmentioning

confidence: 99%

Predictors of stillbirth among women who had given birth in Southern Ethiopia, 2020: A case-control study

et al. 2021

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Background Although the rate of stillbirth has decreased globally, it remains unacceptably high in low- and middle-income countries. Only ten countries including Ethiopia attribute more than 65% of global burden of still birth. Ethiopia has the 7th highest still birth rate in the world. Identifying the predictors of stillbirth is critical for developing successful interventions and monitoring public health programs. Although certain studies have assessed the predictors of stillbirth, they failed in identify the proximate predictors of stillbirth. In addition, the inconsistent findings in identify the predictors of stillbirth, and the methodological limitations in previously published works are some of the gaps. Therefore, this study aimed to identify the predictors of stillbirth among mothers who gave birth in six referral hospitals in Southern, Ethiopia. Methods A hospital-based unmatched case-control study was conducted in six referral hospitals in Southern, Ethiopia from October 2019 to June 2020. Consecutive sampling techniques and simple random techniques were used to recruit cases and controls respectively. A structured standard tool was used to identify the predictors of stillbirth. Data were entered into Epi Info 7 and exported to SPSS 23 for analysis. A multivariable logistic regression model was used to identify the independent predictors of stillbirth. The goodness of fit was tested using the Hosmer and Lemeshow goodness-of-fit. In this study P-value < 0.05 was considered to declare a result as a statistically significant association. Results In this study 138 stillbirth cases and 269 controls were included. Women with multiple pregnancy [AOR = 2.98, 95%CI: 1.39–6.36], having preterm birth [AOR = 2.83, 95%CI: 1.58–508], having cesarean mode of delivery [AOR = 3.19, 95%CI: 1.87–5.44], having no ANC visit [AOR = 4.17, 95%CI: 2.38–7.33], and being hypertensive during pregnancy [AOR = 3.43, 95%CI: 1.93–6.06] were significantly associated with stillbirth. Conclusions The predictors of stillbirth identified are manageable and can be amenable to interventions. Therefore, strengthening maternal antenatal care utilization should be encouraged by providing appropriate information to the mothers. There is a need to identify, screen, and critically follow high-risk mothers: those who have different complications during pregnancy, and those undergoing cesarean section due to different indications.

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“… 17 , 19 Such adverse delivery outcomes can be associated with detrimental outcomes for the mother and the infant over the long term. 47 , 48 …”

Section: Discussionmentioning

confidence: 99%

Comparison of Childbirth Delivery Outcomes and Costs of Care Between Women Experiencing vs Not Experiencing Homelessness

et al. 2021

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IMPORTANCE Women and families constitute the fastest-growing segments of the homeless population. However, there is limited evidence on whether women experiencing homelessness have poorer childbirth delivery outcomes and higher costs of care compared with women not experiencing homelessness. OBJECTIVETo compare childbirth delivery outcomes and costs of care between pregnant women experiencing homelessness vs those not experiencing homelessness. DESIGN, SETTING, AND PARTICIPANTSThis cross-sectional study included 15 029 pregnant women experiencing homelessness and 308 242 pregnant women not experiencing homelessness who had a delivery hospitalization in 2014. The study used statewide databases that included all hospital admissions in 3 states (ie, Florida, Massachusetts, and New York). Delivery outcomes and delivery-associated costs were compared between pregnant women experiencing homelessness and those not experiencing homelessness cared for at the same hospital (analyzed using the overlap propensity-score weighting method and multivariable regression models with hospital fixed effects).The Benjamini-Hochberg false discovery rate procedure was used to account for multiple comparisons. Data were analyzed from January 2020 through May 2020.EXPOSURE Housing status at delivery hospitalization. MAIN OUTCOMES AND MEASURES Outcome variables included obstetric complications (ie,antepartum hemorrhage, placental abnormalities, premature rupture of the membranes, preterm labor, and postpartum hemorrhage), neonatal complications (ie, fetal distress, fetal growth restriction, and stillbirth), delivery method (ie, cesarean delivery), and delivery-associated costs. RESULTS Among 15 029 pregnant women experiencing homelessness (mean [SD] age, 28.5 [5.9] years) compared with 308 242 pregnant women not experiencing homelessness (mean [SD] age, 29.4 [5.8] years) within the same hospital, those experiencing homelessness were more likely to experience preterm labor (adjusted probability, 10.

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Stillbirth is associated with increased risk of long-term maternal renal disease: a nationwide cohort study

Cited by 13 publications

References 37 publications

Hypertensive disorders of pregnancy and the risk of chronic kidney disease: A Swedish registry-based cohort study

Hypertensive disorders of pregnancy and the risk of chronic kidney disease: A Swedish registry-based cohort study

Predictors of stillbirth among women who had given birth in Southern Ethiopia, 2020: A case-control study

Comparison of Childbirth Delivery Outcomes and Costs of Care Between Women Experiencing vs Not Experiencing Homelessness

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