Jessica Sheehan Tangren
Gestational dysglycemia and hypertension occurred more often in women with a history of nephrolithiasis in study results presented at the American Society of Nephrology’s Kidney Week.
“Recent research has shown that women who form kidney stones are at increased risk for certain chronic diseases such as diabetes and high BP,” Jessica Sheehan Tangren, MD, research fellow in medicine at Brigham and Women's Hospital in Boston, told Healio Family Medicine. “We were interested in assessing if women who form kidney stones prior to pregnancy are at increased risk for developing gestational diabetes and gestational hypertension, including preeclampsia.”
Researchers performed a retrospective cohort study of women who gave birth at a Massachusetts hospital and had an abdominal ultrasound or CT completed prior to gestation. Pregnancy outcomes in women without stones on imaging (n = 1,330) were compared with those who had documented stones on imaging (n = 174). Women who had preexisting diabetes, hypertension and chronic kidney disease were not included.
Researchers found that maximum systolic BP during pregnancy increased in those with kidney stones vs. those without despite similar first trimester BP. Gestational hypertension was more common in women with kidney stones (19% vs. 13%, P = .04), as was gestational diabetes (18% vs. 6%, P < .01). After a multivariate adjustment of the data, stones were associated with increased risk for preeclampsia, gestational diabetes and preterm delivery.
“This risk was the highest in women who were overweight or obese before becoming pregnant,” Tangren said. “Fortunately, we did not observe increased rates of complications for the baby after delivery.”
She acknowledged that the findings need to be confirmed elsewhere, but also suggested that their results add another layer of information for primary care physicians to provide to women who are thinking of becoming pregnant.
“At this point it is too early to know how this will impact clinical practice, and the results of our study need to be validated in other cohorts,” Tangren said. “Obesity, however, increases the risk of pregnancy complications and our study suggests that this is especially true in women who form kidney stones. Losing weight before pregnancy is the best way to decrease the risk of problems caused by obesity.” – by Janel Miller
Tangren J, et al. Abstract 2257007. Presented at: American Society of Nephrology Kidney Week. Annual Meeting. Oct. 31–Nov. 5, 2017; New Orleans.
Tangren reports no relevant financial disclosures. Healio Family Medicine was unable to determine the other authors’ relevant financial disclosures prior to publication.