Pregnancy outcomes in patients with acute kidney injury during pregnancy: a
systematic review and meta-analysis
#MMPMID28720086
Liu Y
; Ma X
; Zheng J
; Liu X
; Yan T
BMC Pregnancy Childbirth
2017[Jul]; 17
(1
): 235
PMID28720086
show ga
BACKGROUND: Presently, the matter of pregnancy outcomes of patients with
pregnancy related AKI (PR-AKI) were disputed. Thus, we conducted a meta-analysis
to evaluate the impact of PR-AKI on pregnancy outcomes. METHOD: We systematically
searched MEDLINE, Embase, VIP, CNKI and Wanfang Databases for cohort or
case-control studies in women with PR-AKI and those without AKI as a control
group to assess the influence of PR-AKI on pregnancy outcomes and kidney outcome.
Reduction of odd ratio (OR) was calculated by a random-effects model. RESULTS:
One thousand one hundred fifty two articles were systematically reviewed, of
those 11 studies were included, providing data of 845 pregnancies in 834 women
with PR-AKI and 5387 pregnancies in 5334 women without AKI. In terms of maternal
outcomes, women with PR-AKI had a greater likelihood of cesarean delivery (OR,
1.49; 95% confidence interval [CI], 1.37 to 1.61), hemorrhage (1.26; 1.02 to
1.56), HELLP syndrome (1.86; 1.41 to 2.46), placental abruption (3.13; 1.96 to
5.02), DIC (3.41; 2.00 to 5.84), maternal death (4.50; 2.73 to 7.43), but had a
lower risk of eclampsia (0.53; 0.34 to 0.83). Women with PR-AKI also had a longer
stay in ICU (weighted mean difference, 2.13 day [95% CI 1.43 to 2.83 day])
compared with those without PR-AKI. As for fetal outcomes, higher incidence of
stillbirth/perinatal death (3.39, 2.76 to 4.18), lower mean gestational age at
delivery (-0.70 week [95% CI -1.21 to -0.19 week]) and lower birth weight (-740 g
[95% CI -1180 to 310 g]) were observed in women with PR-AKI. The occurrence of
kidney outcome, defined as ESRD requiring dialysis, in women with PR-AKI was 2.4%
(95% CI 1.3% to 4.2%). CONCLUSIONS: PR-AKI remains a grave complication and has
been associated with increased maternal and fetal mortality.
|*Maternal Mortality
[MESH]
|Acute Kidney Injury/*mortality
[MESH]
|Adult
[MESH]
|Delivery, Obstetric/*statistics & numerical data
[MESH]
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