Coles Helen, Steer Philip, Hughes Polly, Cauldwell Matthew
Department of Obstetrics, Maternal Medicine Service, St George's Hospital, Blackshaw Road, London, SW17 0QT, United Kingdom.
Academic Department of Obstetrics and Gynaecology, Chelsea and Westminster Hospital, 369 Fulham Road, London, SW10 9NH, United Kingdom.
Eur J Obstet Gynecol Reprod Biol. 2021 Jun;261:200-204. doi: 10.1016/j.ejogrb.2021.04.036. Epub 2021 Apr 27.
To investigate the incidence of risk factors associated with acute kidney injury(AKI) occurring during the intrapartum or the immediate postpartum period.
A retrospective case control study in a tertiary UK hospital of pregnant women identified with AKI in labour or in the postpartum period between July 2019 and June 2020 was carried out. Women identified with pregnancy related AKI (pr-AKI) in labour or postpartum were compared with a matched cohort of women with no evidence of pr-AKI, using multiple regression analysis.
In 4600 births, 71 women with pr-AKI and 142 control women were identified. The antenatal and intrapartum risk factors strongly associated with pr-AKI were pre-eclampsia, prolonged ruptured membranes, delivery by emergency caesarean section and greater blood loss at delivery (all p < 0.001 in multivariable regression).
Pr-AKI is relatively common, occurring in 1.5 % of our cohort. Women who are overweight, have prolonged rupture of the membranes, an emergency caesarean section and/or a postpartum haemorrhage are at greatest risk. Clinicians should be check renal function before prescribing non-steroidal medication for postpartum pain relief if there are risk factors for AKI.
调查产时或产后即刻发生急性肾损伤（AKI）相关危险因素的发生率。
在英国一家三级医院开展了一项回顾性病例对照研究，研究对象为2019年7月至2020年6月期间分娩时或产后被诊断为AKI的孕妇。采用多元回归分析，将分娩时或产后被诊断为妊娠相关AKI（pr-AKI）的女性与无pr-AKI证据的匹配队列女性进行比较。
在4600例分娩中，确定了71例pr-AKI女性和142例对照女性。与pr-AKI密切相关的产前和产时危险因素为子痫前期、胎膜早破、急诊剖宫产分娩和分娩时失血较多（多变量回归中所有p<0.001）。
Pr-AKI相对常见，在我们的队列中发生率为1.5%。超重、胎膜破裂时间延长、急诊剖宫产分娩和/或产后出血的女性风险最高。如果存在AKI危险因素，临床医生在开具非甾体类药物用于产后止痛前应检查肾功能。
