• Li Dai, Yue Chen, Wen Sun, and Shiliang Liu.
• School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON; Maternal, Child and Youth Health Division, Centre for Surveillance and Applied Research, Health Promotion and Chronic Disease Prevention Branch, Public Health Agency of Canada, Ottawa, ON.
• J Obstet Gynaecol Can. 2018 Sep 1; 40 (9): 1129-1138.

ObjectiveTo assess whether hypertensive disorders during pregnancy (HDPs) are associated with the subsequent development of end-stage renal disease (ESRD).MethodsThe present study included 1 598 043 women who delivered in Canadian hospitals between April 1993 and March 2003. The baseline information was from the Canadian Institute for Health Information's Discharge Abstract Database. Women with chronic kidney disease, diabetes mellitus, and other specific conditions were excluded. A follow-up study was conducted through a record linkage on their hospitalizations as of the 13th month after the delivery discharge through March 31, 2013. The primary outcome of interest was subsequent hospitalization due to ESRD. Cox model was used to quantify the association between HDPs and ESRD hospitalization.ResultsThere occurred 9.9 and 1.7 ESRD hospitalizations per 100 000 person-years in the follow-up of HDPs and non-HDP women, respectively. An increased risk of ESRD hospitalization was observed in pregnant women with pre-eclampsia/eclampsia (adjusted hazard ratio [aHR] = 4.7, 95% CI 3.6-6.0), unspecified HDPs (aHR = 4.6, 95% CI 2.8-7.7), or gestational hypertension (aHR = 3.3, 95% CI 2.1-5.1). Caesarean delivery, preterm delivery, IUGR, and deep vein thrombosis were identified as significant correlates with the subsequent ESRD hospitalization. The risk of subsequent ESRD hospitalization appeared to be lower for women who had ≥2 deliveries compared with those who had one delivery during the study period.ConclusionPregnancy complicated with HDPs was significantly associated with an increased risk of ESRD hospitalization in later life, and this association varied by HDP subtype and frequency of delivery.Crown Copyright © 2018. Published by Elsevier Inc. All rights reserved.

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