Adverse pregnancy outcomes, longitudinal change in eGFR, and incident hypertension in women: a population-based...

As the traditional risk factors cannot account for all hypertension (HTN) incidents, it is of great importance to determine other risk factors. This study aimed to identify long-term HTN risk associated with annual change of estimated glomerular filtration rate (eGFR) and prior adverse pregnancy outcomes (APOs) among women participating in a population-based study of Tehran Lipid and Glucose Study (TLGS).

This study was performed using prospectively ascertained data of TLGS. A total of 2,404 women with recorded data of eGFR measurements and APO status participated. Data collection was conducted according to the standard guide of TLGS. Cox proportional-hazards regression models were used to estimate the hazard ratios (HRs) and their 95% confidence intervals (CIs) for the incidence of HTN.

A total of 2,404 women were enrolled. Adjusted model shows that, a one z-score positive eGFR change was associated with a reduced risk of developing HTN among women with a history of APOs (HR= 0.816, 95% CI: 0.708-0.939, p = 0.005). In contrast, no significant association was observed among women without a history of APOs (HR= 1.027, 95% CI: 0.913-1.156, p = 0.645). We also observed a statistically significant interaction between APO status and annual eGFR change for HTN incidence in total population (interaction p = 0.02).

The history of APOs is accompanied by alterations in kidney function in the long term. In women with a history of APOs, a positive change in eGFR levels was independently associated with a lower risk of HTN.