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

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

Marissa J DeFreitas  1 , Russell Griffin  2 , Keia Sanderson  3 , Arwa Nada  4 , Jennifer R Charlton  5 , Jennifer G Jetton  6 , Alison L Kent  7   8 , Ronnie Guillet  7 , David Askenazi  9 , Carolyn L Abitbol  1 ; Neonatal Kidney Collaborative; University of Alabama, Birmingham; Cincinnati Children's Hospital; Canberra Hospital; (currently at the University of Rochester); Children's Hospital of Colorado; (currently Cincinnati Children's Hospital, Cincinnati, OH); Children's Hospital at Montefiore/Albert Einstein; Children's National Medical Center; Golisano Children's Hospital University of Rochester; (currently Union Hospital, Terre Haute); Maimonides Medical Center; McGill University; Medanta, Medicity The Cradle; Metrohealth Medical Center; Nationwide Children's Hospital; Stonybrook University; Texas Children's Hospital; Tufts Medical Center; University of British Columbia; University of Iowa; Patrick Brophy (currently University of Rochester); University of Kentucky; University of Miami; University of Michigan; (currently Medical University of South Carolina); University of New Mexico; (currently Texas Children's Hospital); (currently University of Utah); University of Virginia; (currently University of Wisconsin); University of Washington
Collaborators, Affiliations

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

Marissa J DeFreitas et al. Am J Perinatol. 2024 Apr.

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..

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Conflict of interest statement

We provide here an additional list of other author's commitments and funding sources that are not directly related to this study: D.A. is a consultant for Baxter, CHF solutions, Medtronic Bioporto and the AKI Foundation. He receives grant funding for studies not related to this project from Baxter, CHF solutions, Medtronic, and National Institutes of Health (identifier no.: U34 DK117128) J.C. is a coowner of Sindri Technologies, LLC. She receives funding from the National Institute of Health (NIH) National Institutes of Diabetes and Digestive and Kidney Diseases. (NIDDK; identifier numbers: R01DK110622, R01DK111861, and P50DK096373).

Figures

Fig. 1
Fig. 1
Flow diagram of enrollment of patients into the AWAKEN study. Because exclusion criteria are not mutually exclusive, some potential participants could have been excluded for multiple reasons and are counted in each exclusion category. AKI, acute kidney injury; AWAKEN, the Assessment of Worldwide Acute Kidney Epidemiology in Neonates; Cr, creatinine; IVF, in vitro fertilization; NICU, neonatal intensive care unit; UOP, urine output.
Fig. 2
Fig. 2
Forest plot showing maternal HTN by category alongside other variables associated with early AKI. Crude odds ratios (OR) are in red and adjusted OR are in blue. AKI, acute kidney injury; FGR, fetal growth restriction; GA, gestational age; HTN, hypertension.
See this image and copyright information in PMC

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