Stillbirth is associated with increased risk of long-term maternal renal disease: a nationwide cohort study.

Abstract:
BACKGROUND:Stillbirth is a devastating adverse pregnancy outcome which may occur without any obvious reason, or may occur in the context of fetal growth restriction, preeclampsia or other obstetric complications. There is increasing evidence that women who experience stillbirths are at higher risk of long-term cardiovascular disease (CVD), but little is known about their risk of chronic kidney disease (CKD) and end-stage renal disease (ESRD). We conducted the largest study to date to investigate the subsequent risk of maternal CKD and ESRD following stillbirth. OBJECTIVE:To identify whether pregnancy complicated by stillbirth is associated with subsequent risk of maternal CKD and ESRD, independent of underlying medical or obstetric comorbidities. STUDY DESIGN/METHODS:We conducted a population-based cohort study using nationwide data from the Swedish Medical Birth Register, National Patient Register and Swedish Renal Register. We included all women who had live births and stillbirths from 1973 to 2012, with follow-up to 2013. Women with pre-existing renal disease were excluded. Cox proportional hazard regression models were used to estimate adjusted hazard ratios (aHR) and 95% confidence intervals (CI) for associations between stillbirth and maternal CKD and ESRD respectively. We controlled for maternal age, year of delivery, country of origin, parity, body mass index, smoking, gestational diabetes, preeclampsia, and small for gestational age (SGA) deliveries. Women who had a history of medical comorbidities, which may predispose to renal disease (pre-pregnancy CVD, hypertension, diabetes, lupus, systemic sclerosis, hemoglobinopathy, or coagulopathy), were excluded from the main analysis and examined separately. RESULTS:There were 1,941,057 unique women who had 3,755,444 singleton pregnancies, followed up over 42,313,758 person-years. The median follow-up time was 20.7 years (interquartile range 9.9-30.0 years). 13,032 women (0.7%) had at least one stillbirth. Women who had experienced at least one stillbirth had a higher risk of developing CKD (adjusted hazard ratio (aHR) 1.26, 95% CI 1.09-1.45) and ESRD (aHR 2.25, 95% CI 1.55-3.25) compared to women who only had live births. These associations persisted after removing all stillbirths which occurred in the context of preeclampsia, SGA or congenital malformations (for CKD, aHR 1.33, 95% CI 1.13-1.57; for ESRD, aHR 2.95, 95% CI 1.86-4.68). There was no significant association observed between stillbirth and either CKD or ESRD in women who had pre-existing medical comorbidities (CKD, aHR 1.13, 95% CI 0.73-1.75; ESRD, aHR 1.49, 95% CI 0.78-2.85). CONCLUSION:Women who have a history of stillbirth may be at increased risk of CKD and ESRD compared to women who have only had live births. This association persists independently of preeclampsia, SGA, maternal smoking, obesity, and medical comorbidities. Further research is required to determine whether affected women would benefit from closer surveillance and follow-up for future renal disease.
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AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
AM J OBSTET GYNECOL
最新影响因子:10.693 | 期刊ISSN:0002-9378 | CiteScore:3.5 |
出版周期:Monthly | 是否OA:YES | 出版年份:1920 |
期刊官方网址:http://www.ajog.org/
自引率:11.90% | 研究方向:医学-妇产科学 |
出版地区:UNITED STATES |
SCI期刊coverage:Science Citation Index Expanded(科学引文索引扩展)
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AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY 期刊简介
英文简介:
The American Journal of Obstetrics and Gynecology, “The Gray Journal”, covers the full spectrum of Obstetrics and Gynecology. The aim of the Journal is to publish original research (clinical and translational), reviews, opinions, video clips, podcasts and interviews that will have an impact on the understanding of health and disease and that has the potential to change the practice of women's health care. An important focus is the diagnosis, treatment, prediction and prevention of obstetrical and gynecological disorders. The Journal also publishes work on the biology of reproduction, and content which provides insight into the physiology and mechanisms of obstetrical and gynecological diseases.
中文简介:(来自Google、百度翻译)
美国妇产科杂志,“灰色杂志”,涵盖了妇产科的所有领域。该杂志的目的是发表原创研究(临床和翻译)、评论、意见、视频剪辑、播客和访谈,这些将对健康和疾病的理解产生影响,并有可能改变妇女保健的做法。妇产科疾病的诊断、治疗、预测和预防是一个重要的研究重点。该杂志还出版了生殖生物学方面的著作,内容涉及妇产科疾病的生理学和机制。 好处的作者
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY 期刊中科院评价数据
最新中科院分区
大类(学科) | 小类(学科) | 学科排名 |
医学 |
OBSTETRICS & GYNECOLOGY(产科医学和妇科医学) 1区 |
2/82 |
最新公布的期刊年发文量
年度总发文量 | 年度论文发表量 | 年度综述发表量 |
343 | 310 | 33 |
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AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY 期刊CiteScore评价数据
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引文计数(2018)
文献(2015-2017)
6254次引用
1788篇文献
CiteScore排名
序号 | 类别 | 排名 | 百分位 |
1 |
大类(学科):Medicine
小类(学科):Obstetrics and Gynecology
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#5/168
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liting7111
研究方向:妇产科
写了篇流行病方向文章,同门的投稿都是一个月就审回,我两个月才审回,5个审稿人给了拒绝,但是可以修改后重投,大修再投两个月还是被拒了。2020-06-11 -
liting7111
研究方向:妇产科
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liting7111
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liting7111
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liting7111
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之前投稿gynecology oncology被拒,按照意见修改后去年12月投稿,两个月修回,小修之后四个月接收,4月底在线,杂志还是偏临床。2019-05-12
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