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

Am J Perinatol. 2024 Apr;41(5):649-659. doi: 10.1055/a-1780-2249. Epub 2022 Feb 23.

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: · Maternal HTN is associated with less neonatal AKI.. · Maternal HTN category is variably associated with AKI.. · Inborn status is an important contributor to this association..

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

MeSH terms

  • Acute Kidney Injury* / complications
  • Acute Kidney Injury* / etiology
  • Eclampsia*
  • Female
  • Humans
  • Hypertension* / complications
  • Hypertension* / epidemiology
  • Infant, Newborn
  • Intensive Care Units, Neonatal
  • Pre-Eclampsia* / epidemiology
  • Pregnancy
  • Retrospective Studies