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DOI: 10.1055/a-1780-2249
Maternal Hypertension Disorders and Neonatal Acute Kidney Injury: Results from the AWAKEN Study
Funding Cincinnati Children's Hospital Center for Acute Care Nephrology provided funding to create and maintain the Assessment of Worldwide Acute Kidney Epidemiology in Neonates (AWAKEN) Medidata Rave electronic database. The Pediatric and Infant Center for Acute Nephrology (PICAN) provided support for web meetings, for the Neonatal Kidney Collaborative steering committee annual meeting at the University of Alabama at Birmingham (UAB), as well as support for some of the AWAKEN investigators at UAB (D.A. David Askenazi, and R.G. Russell Griffin). PICAN is a part of the Department of Pediatrics at UAB, and is funded by Children's of Alabama Hospital, the Department of Pediatrics, UAB School of Medicine, and UAB's Center for Clinical and Translational Sciences (National Institutes of Health [2] grant UL1TR001417). The AWAKEN study was supported at the University of New Mexico by the Clinical and Translational Science Center (National Institute of Health grant, number: UL1TR001449).
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
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Maternal HTN is associated with less neonatal AKI.
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Maternal HTN category is variably associated with AKI.
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Inborn status is an important contributor to this association.
Ethical Approval
Each center received approval from their Human Research Ethics Committee or Institutional Review Board and consent was waived.
Author's Contribution
M.J.D. and C.L.A. designed the study, acquired data, drafted the manuscript, and approved the final version. K.S. and D.A., contributed to the design of the study, edited the manuscript, and approved the final version. R.Gu. acquired data, contributed to the design of the study, edited the manuscript, and approved the final version. R.Gr. contributed to the design of the study, performed the statistical analyses, edited the manuscript, and approved the final version. A.N., J.C., J.G.J., and A.L.K. acquired data, edited the manuscript, and approved the final version.
Publikationsverlauf
Eingereicht: 08. November 2021
Angenommen: 08. Februar 2022
Accepted Manuscript online:
23. Februar 2022
Artikel online veröffentlicht:
18. April 2022
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