Maternal Hypertension Disorders and Neonatal Acute Kidney Injury: Results from the AWAKEN Study

Author:

DeFreitas Marissa J.1ORCID,Griffin Russell2,Sanderson Keia3,Nada Arwa4,Charlton Jennifer R.5,Jetton Jennifer G.6,Kent Alison L.78,Guillet Ronnie7,Askenazi David9,Abitbol Carolyn L.1, , , , , , , , , , , , , , , , , , , , , , , , , , , , ,

Affiliation:

1. Department of Pediatrics, Division of Pediatric Nephrology, University of Miami/Holtz Children's Hospital, Miami, Florida

2. Department of Epidemiology, University of Alabama Birmingham, Birmingham, Alabama

3. Department of Medicine, Division of Nephrology and Hypertension, University of North Carolina, Chapel Hill, North Carolina

4. Department of Pediatrics, Division of Nephrology & Hypertension Le Bonheur Children's Hospital, The University of Tennessee Health Science Center, Memphis, Tennessee

5. Department of Pediatrics, Division of Nephrology, University of Virginia, Charlottesville, Virginia

6. Department of Pediatrics, Division of Nephrology, Dialysis and Transplantation, University of Iowa Stead Family Children's Hospital, Iowa City, Iowa

7. Department of Pediatrics, University of Rochester, Rochester, New York

8. Department of Pediatrics, Australian National University, ACT, Australia

9. Department of Pediatrics, Division of Nephrology, University of Alabama Birmingham, Birmingham, Alabama

Abstract

Objective This study aimed to examine the association between maternal hypertension (HTN) exposure and neonatal acute kidney injury (AKI). 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

Funder

PICAN

University of New Mexico by the Clinical and Translational Science Center

Publisher

Georg Thieme Verlag KG

Subject

Obstetrics and Gynecology,Pediatrics, Perinatology and Child Health

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