Table 3.
Hazard ratios for maternal chronic kidney disease and end-stage renal disease by history of stillbirth, among women delivering between 1973 and 2012 in Sweden, excluding pregnancies complicated by congenital malformations, small for gestational age, and preeclampsia
| Chronic kidney disease |
End-stage renal disease |
|||||
|---|---|---|---|---|---|---|
| n | Age-adjusted |
Fully adjusted |
n | Age-adjusted |
Fully adjusted |
|
| HR (95% CI) | HR (95% CI) | HR (95% CI) | HR (95% CI) | |||
| Excluding deliveries with congenital malformations | ||||||
| No stillbirth | 16,954 | 1.0 | 1.0 | 1,177 | 1.0 | 1.0 |
| Stillbirth (any) | 186 | 1.56 (1.35–1.80) | 1.25 (1.08–1.44) | 27 | 3.03 (2.07–4.44) | 2.08 (1.41–3.10) |
| Further excluding SGA deliveries | ||||||
| No stillbirth | 16,211 | 1.0 | 1.0 | 1,089 | 1.0 | 1.0 |
| Stillbirth (any) | 155 | 1.46 (1.24–1.71) | 1.29 (1.10–1.51) | 21 | 2.77 (1.80–4.28) | 2.43 (1.57–3.76) |
| Further excluding preeclamptic deliveries | ||||||
| No stillbirth | 15,370 | 1.0 | 1.0 | 959 | 1.0 | 1.0 |
| Stillbirth (any) | 144 | 1.45 (1.23–1.71) | 1.33 (1.13–1.57) | 19 | 2.94 (1.87–4.63) | 2.95 (1.86–4.68) |
HRs represent separate Cox regression models for associations between stillbirth and maternal chronic kidney disease or end-stage renal disease. In all models, delivery of a stillbirth was a time-dependent variable, where maternal exposure status was based on the date of first stillbirth.
Pregnancies complicated by congenital malformations, small for gestational age, or preeclampsia were sequentially excluded.
Fully adjusted models controlled for maternal age, country of origin, maternal education, parity, antenatal BMI, smoking, and maternal exposure to gestational diabetes (time-dependent covariate), stratified by year of delivery. Models were initially adjusted for preeclampsia and SGA delivery (time-dependent covariates) before exclusion of these deliveries from the dataset.
Women with prepregnancy history of renal disease, cardiovascular disease, hypertension, diabetes, systemic lupus erythematosus, systemic sclerosis, hemoglobinopathy or coagulopathy were excluded at baseline.
BMI, body mass index; CI, confidence interval; HR, hazard ratio; SGA, small for gestational age.
Barrett et al. Stillbirth is associated with increased risk of long-term maternal renal disease: a nationwide cohort study. Am J Obstet Gynecol 2020.