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Meta-Analysis
. 2017 Jul 18;17(1):235.
doi: 10.1186/s12884-017-1402-9.

Pregnancy outcomes in patients with acute kidney injury during pregnancy: a systematic review and meta-analysis

Youxia Liu  1 , Xinxin Ma  2 , Jie Zheng  3 , Xiangchun Liu  4 , Tiekun Yan  5
Affiliations
Meta-Analysis

Pregnancy outcomes in patients with acute kidney injury during pregnancy: a systematic review and meta-analysis

Youxia Liu et al. BMC Pregnancy Childbirth. .

Abstract

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.

Keywords: Acute kidney injury; Kidney outcome; Meta-analysis; Pregnancy outcomes.

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Conflict of interest statement

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Competing interests

None declared.

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Figures

Fig. 1
Fig. 1
Process for identifying studies eligible for the meta-analysis
Fig. 2
Fig. 2
Hazard ratios of maternal death for pregnant women with versus without acute kidney injury
Fig. 3
Fig. 3
Hazard ratios of fetal death for pregnant women with versus without acute kidney injury
Fig. 4
Fig. 4
Subgroup analysis of the hazard ratios of fetal death for pregnant women with versus without acute kidney injury
See this image and copyright information in PMC

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