Pre-pregnancy kidney function and subsequent adverse pregnancy outcomes

Area of Science:

• Obstetrics and Gynecology
• Nephrology
• Reproductive Health

Background:

• Renal insufficiency is a known risk factor for adverse pregnancy outcomes like fetal growth restriction and pre-eclampsia.
• Understanding the impact of normal-range kidney function before conception is crucial for optimizing maternal and infant health.

Purpose of the Study:

• To investigate the association between preconception kidney function, specifically within the normal range, and various pregnancy outcomes.
• To determine if changes in kidney function over time influence pregnancy results.

Main Methods:

• Analysis of data from 1043 women in the CARDIA study with pre-pregnancy kidney function measurements.
• Estimated glomerular filtration rate (eGFR), serum creatinine, and urinary albumin/creatinine ratio were used to assess kidney function.
• Multiple regression models adjusted for confounders were employed to evaluate predictors of infant birthweight, gestational age, and hypertensive disorders.

Main Results:

• Pre-pregnancy eGFR within the normal range showed no significant association with birthweight or gestational age after adjusting for confounders.
• A decline in estimated glomerular filtration rate (eGFR) from baseline to year 10 was associated with lower birthweight, especially in white women.
• No association was found between preconception kidney function and hypertensive disorders of pregnancy.

Conclusions:

• Preconception kidney function within the normal range does not appear to be a strong predictor of birthweight or gestational age.
• Further research is needed to explore potential racial differences in the relationship between kidney function and pregnancy outcomes.