Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Ginecologia e Obstetrícia, Campinas, SP, Brazil.
J Bras Nefrol. 2023 Jul-Sep;45(3):294-301. doi: 10.1590/2175-8239-JBN-2022-0119en.
Pregnancy-related complications may impact women's reproductive cycle and health through their lives. The objective of this study was to evaluate the sociodemographic, clinical, and obstetric history of women undergoing hemodialysis.
We performed a cross-sectional study in a specialized health facility with four hemodialysis units. Sociodemographic characteristics, clinical and personal history, obstetric and perinatal results of women with pregnancies before hemodialysis were evaluated. Prevalence, bivariate, and logistic regression analyses were performed.
We included 208 (87.76%) women. Hypertension was the main cause of chronic kidney disease (CKD) (128 women). Rates of adverse perinatal outcomes, including prematurity, low birth weight, miscarriage, fetal death, and neonatal death, were 19.3%, 14.5%, 25.5%, 12.1%, and 5.3%, respectively. Hypertensive syndromes during pregnancy occurred in 37.0% of women, with 12.5% reporting preeclampsia and 1.4% reporting eclampsia. Up to 1 year after birth, 45.2% of women reported hypertension. Hemodialysis due to hypertension was associated with a history of hypertension during pregnancy (OR 2.33, CI 1.27 - 4.24), gestational hypertension (2.41, CI 3.30 - 4.45), and hypertension up to one year after birth (OR 1.98, CI 1.11 - 3.51). Logistic regression showed that gestational hypertension was independently associated with CKD due to hypertension (aOR 2.76, CI 1.45 - 5.24).
Women undergoing hemodialysis due to hypertension were more likely to have gestational hypertension or hypertension up to one year after birth. To delay end-stage renal disease, it is necessary to identify women at risk of kidney failure according to their reproductive history.
与妊娠相关的并发症可能会通过女性的一生影响其生殖周期和健康。本研究的目的是评估接受血液透析的女性的社会人口学、临床和产科病史。
我们在一家拥有四个血液透析单位的专业医疗机构进行了一项横断面研究。评估了在血液透析前有妊娠史的女性的社会人口学特征、临床和个人病史、产科和围产儿结局。进行了患病率、双变量和逻辑回归分析。
我们纳入了 208 名（87.76%）女性。高血压是导致慢性肾脏病（CKD）的主要原因（128 名女性）。不良围产儿结局的发生率包括早产、低出生体重、流产、胎儿死亡和新生儿死亡，分别为 19.3%、14.5%、25.5%、12.1%和 5.3%。妊娠期间发生高血压综合征的女性占 37.0%，其中 12.5%报告有子痫前期，1.4%报告有子痫。产后 1 年内，45.2%的女性报告有高血压。因高血压而进行血液透析与妊娠期间高血压（OR 2.33，CI 1.27-4.24）、妊娠期高血压（2.41，CI 3.30-4.45）和产后 1 年内高血压（OR 1.98，CI 1.11-3.51）有关。逻辑回归显示，妊娠期高血压与高血压导致的 CKD 独立相关（aOR 2.76，CI 1.45-5.24）。
因高血压而接受血液透析的女性更有可能患有妊娠期高血压或产后 1 年内高血压。为了延缓终末期肾病的发生，有必要根据女性的生殖史识别有肾衰竭风险的女性。
