Obstetric outcomes in pregnancies complicated by polycystic kidney disease

Polycystic kidney disease (PKD) is a genetic condition characterized by the growth of multiple renal cysts that affect kidney function. Although the disease is present from conception, individuals with the more common form of the disease, autosomal dominant PKD, often remain asymptomatic until after reproductive age. There is a paucity of large studies on PKD and obstetric outcomes; hence, the purpose of the present study is to evaluate maternal and neonatal/fetal outcomes in patients with PKD.

A retrospective cohort study was executed using the 2016-2021 Healthcare Cost Utilization Project-National Inpatient Sample, an American database. Among a cohort of pregnant patients, ICD-10 codes Q61.x were used to identify cases of PKD. The adjusted effects of PKD on maternal and neonatal outcomes were evaluated using multivariable logistic regression models, controlling for maternal age.

Compared with non-PKD patients, those with PKD were more often Caucasian, obese, and had pre-existing hypertension and chronic kidney disease. PKD patients were more likely to deliver via cesarean section and experience obstetric complications, including preeclampsia, gestational diabetes, anemia, genitourinary tract infections, abruptio placenta, postpartum hemorrhage, sepsis, renal calculi, acute renal failure, and death. Neonates born to PKD patients were at greater risk of preterm birth, intrauterine growth restriction, and congenital anomalies.

PKD patients and their fetuses are at greater risk for obstetric complications and should be considered high-risk patients. As such, their pregnancies should be followed closely by a multi-disciplinary team of obstetricians, nephrologists, and neonatologists.