Maternal Hypertension Disorders and Neonatal Acute Kidney Injury: Results from the AWAKEN Study.
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DeFreitas Marissa J, Griffin Russell, Sanderson Keia, Nada Arwa, Charlton Jennifer R, Jetton Jennifer G, Kent Alison L, Guillet Ronnie, Askenazi David, Abitbol Carolyn L, Neonatal Kidney Collaborative, University of Alabama, Birmingham, Cincinnati Children's Hospital, Canberra Hospital, (currently at the University of Rochester), Children's Hospital of Colorado, (currently Cincinnati Children's Hospital, Cincinnati, OH); Children's Hospital at Montefiore/Albert Einstein, Children's National Medical Center, Golisano Children's Hospital University of Rochester, (currently Union Hospital, Terre Haute), Maimonides Medical Center, McGill University, Medanta, Medicity The Cradle, Metrohealth Medical Center, Nationwide Children's Hospital, Stonybrook University, Texas Children's Hospital, Tufts Medical Center, University of British Columbia, University of Iowa, Patrick Brophy (currently University of Rochester); University of Kentucky, University of Miami, University of Michigan, (currently Medical University of South Carolina), University of New Mexico, (currently Texas Children's Hospital), (currently University of Utah); University of Virginia, (currently University of Wisconsin), University of Washington
Аннотация
STUDY DESIGN: Retrospective cohort study of 2,162 neonates admitted to 24 neonatal intensive care units (NICUs). Neonates were classified into the following exposure groups: any maternal HTN, chronic maternal HTN, preeclampsia/eclampsia, both, or neither. Demographics, clinical characteristics, and AKI status were compared using Chi-square and analysis of variance. General estimating logistic regression was used to estimate adjusted odds ratios and included a stratified analysis for site of delivery.
RESULT: Neonates exposed to any maternal HTN disorder had a tendency toward less overall and early AKI. When stratified by inborn versus outborn, exposure to both maternal HTN disorders was associated with a significantly reduced odds of early AKI only in the inborn neonates.
CONCLUSION: Exposure to maternal HTN, especially preeclampsia/eclampsia superimposed on chronic HTN, was associated with less likelihood of early AKI in the inborn group.
KEY POINTS: · Maternal HTN is associated with less neonatal AKI.. · Maternal HTN category is variably associated with AKI.. · Inborn status is an important contributor to this association..