Hypertensive disorders of pregnancy and the recent increase in obstetric acute renal failure in Canada: population based retrospective cohort study
Objective To examine whether changes in postpartum haemorrhage, hypertensive disorders of pregnancy, or other risk factors explain the increase in obstetric acute renal failure in Canada.Design Retrospective cohort study.Setting Canada (excluding the province of Quebec).Participants All hospital del...
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| Veröffentlicht in: | BMJ (Online) 2014-07, Vol.349 (7971), p.g4731-g4731 |
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| creator | Mehrabadi, Azar Liu, Shiliang Bartholomew, Sharon Hutcheon, Jennifer A Magee, Laura A Kramer, Michael S Liston, Robert M Joseph, K S |
| description | Objective To examine whether changes in postpartum haemorrhage, hypertensive disorders of pregnancy, or other risk factors explain the increase in obstetric acute renal failure in Canada.Design Retrospective cohort study.Setting Canada (excluding the province of Quebec).Participants All hospital deliveries from 2003 to 2010 (n=2 193 425).Main outcome measures Obstetric acute renal failure identified by ICD-10 diagnostic codes.Methods Information on all hospital deliveries in Canada (excluding Quebec) between 2003 and 2010 (n=2 193 425) was obtained from the Canadian Institute for Health Information. Temporal trends in obstetric acute renal failure were assessed among women with and without postpartum haemorrhage, hypertensive disorders of pregnancy, or other risk factors. Logistic regression was used to determine if changes in risk factors explained the temporal increase in obstetric acute renal failure.Results Rates of obstetric acute renal failure rose from 1.66 to 2.68 per 10 000 deliveries between 2003-04 and 2009-10 (61% increase, 95% confidence interval 24% to 110%). Adjustment for postpartum haemorrhage, hypertensive disorders, and other factors did not attenuate the increase. The temporal increase in acute renal failure was restricted to deliveries with hypertensive disorders (adjusted increase 95%, 95% confidence interval 38% to 176%), and was especially pronounced among women with gestational hypertension with significant proteinuria (adjusted increase 171%, 71% to 329%). No significant increase occurred among women without hypertensive disorders (adjusted increase 12%, −28 to 72%).Conclusions The increase in obstetric acute renal failure in Canada between 2003 and 2010 was restricted to women with hypertensive disorders and was especially pronounced among women with pre-eclampsia. Further study is required to determine the cause of the increase among women with pre-eclampsia. |
| doi_str_mv | 10.1136/bmj.g4731 |
| format | Article |
| fullrecord | <record><control><sourceid>jstor_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4115671</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><jstor_id>26516726</jstor_id><sourcerecordid>26516726</sourcerecordid><originalsourceid>FETCH-LOGICAL-b548t-6efcac71cec3af26ce9a1866b8dd3dfd3961a77353683fe6c5e0b06f8dbf0a753</originalsourceid><addsrcrecordid>eNqNkstu1DAUhiMEoqPSBQ8AsgQLWKT4xLGddIGERkCRKrGBdeTYJzMeZexgO5XmOXhhnE4pF4mLN7Z0Pv_n9hfFY6DnAEy86ve7800tGdwrViC5KKFh7H6xoi1vywZYc1KcxbijlFZMNq3gD4uTilMpm4qviq-XhwlDQhftNRJjow8GQyR-IFPAjVNOH4hyhqQtkoAaXSLW6YAqYn4Q38eEKVhNlJ7Tgjg1kkHZcQ43wFo5ZdQFmfw0jypZ70if_5pMpuDjhDotmbXf-pBITLM5PCoeDGqMeHZ7nxaf3739tL4srz6-_7B-c1X2vG5SKXDQSkvQqJkaKqGxVdAI0TfGMDMY1gpQUjLORMMGFJoj7akYGtMPVEnOTovXR91p7vdolt6CGrsp2L0Kh84r2_0acXbbbfx1VwNwISELvLgVCP7LjDF1exs1jqNy6OfYgQAQrM51_Aea95Vp2f4b5RxoBVDXGX32G7rzc8gbyJTMpwUJ7V8pnkusKyFEpl4eKZ3XEgMOd4MA2i1O67LTuhunZfbpz5O7I7_7KgNPjsAuJh9-xAXPLVZLsufH-KL55zzfADy15wE</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1777791719</pqid></control><display><type>article</type><title>Hypertensive disorders of pregnancy and the recent increase in obstetric acute renal failure in Canada: population based retrospective cohort study</title><source>Applied Social Sciences Index & Abstracts (ASSIA)</source><source>Jstor Complete Legacy</source><source>MEDLINE</source><source>BMJ Journals - NESLi2</source><creator>Mehrabadi, Azar ; Liu, Shiliang ; Bartholomew, Sharon ; Hutcheon, Jennifer A ; Magee, Laura A ; Kramer, Michael S ; Liston, Robert M ; Joseph, K S</creator><creatorcontrib>Mehrabadi, Azar ; Liu, Shiliang ; Bartholomew, Sharon ; Hutcheon, Jennifer A ; Magee, Laura A ; Kramer, Michael S ; Liston, Robert M ; Joseph, K S ; Canadian Perinatal Surveillance System (Public Health Agency of Canada) ; Canadian Perinatal Surveillance System Public Health Agency of Canada ; for the Canadian Perinatal Surveillance System (Public Health Agency of Canada)</creatorcontrib><description>Objective To examine whether changes in postpartum haemorrhage, hypertensive disorders of pregnancy, or other risk factors explain the increase in obstetric acute renal failure in Canada.Design Retrospective cohort study.Setting Canada (excluding the province of Quebec).Participants All hospital deliveries from 2003 to 2010 (n=2 193 425).Main outcome measures Obstetric acute renal failure identified by ICD-10 diagnostic codes.Methods Information on all hospital deliveries in Canada (excluding Quebec) between 2003 and 2010 (n=2 193 425) was obtained from the Canadian Institute for Health Information. Temporal trends in obstetric acute renal failure were assessed among women with and without postpartum haemorrhage, hypertensive disorders of pregnancy, or other risk factors. Logistic regression was used to determine if changes in risk factors explained the temporal increase in obstetric acute renal failure.Results Rates of obstetric acute renal failure rose from 1.66 to 2.68 per 10 000 deliveries between 2003-04 and 2009-10 (61% increase, 95% confidence interval 24% to 110%). Adjustment for postpartum haemorrhage, hypertensive disorders, and other factors did not attenuate the increase. The temporal increase in acute renal failure was restricted to deliveries with hypertensive disorders (adjusted increase 95%, 95% confidence interval 38% to 176%), and was especially pronounced among women with gestational hypertension with significant proteinuria (adjusted increase 171%, 71% to 329%). No significant increase occurred among women without hypertensive disorders (adjusted increase 12%, −28 to 72%).Conclusions The increase in obstetric acute renal failure in Canada between 2003 and 2010 was restricted to women with hypertensive disorders and was especially pronounced among women with pre-eclampsia. Further study is required to determine the cause of the increase among women with pre-eclampsia.</description><edition>International edition</edition><identifier>ISSN: 0959-8138</identifier><identifier>ISSN: 1756-1833</identifier><identifier>ISSN: 0959-8146</identifier><identifier>EISSN: 1756-1833</identifier><identifier>DOI: 10.1136/bmj.g4731</identifier><identifier>PMID: 25077825</identifier><identifier>CODEN: BMJOAE</identifier><language>eng</language><publisher>England: British Medical Journal Publishing Group</publisher><subject>Acute Kidney Injury - epidemiology ; Adult ; Blood ; Blood transfusions ; Canada - epidemiology ; Childbirth & labor ; Cohort Studies ; Delivery, Obstetric ; Drugs ; Female ; Hemorrhage ; Hospitals ; Humans ; Hypertension ; Hypertension - epidemiology ; Hypertension, Pregnancy-Induced - epidemiology ; Kidney diseases ; Kidneys ; Logistic Models ; Medical research ; Obstetrics ; Postpartum Hemorrhage - epidemiology ; Postpartum period ; Preeclampsia ; Pregnancy ; Pregnancy Complications, Cardiovascular - epidemiology ; Proteinuria - epidemiology ; Retrospective Studies ; Risk Factors ; Trends ; Validation studies ; Womens health</subject><ispartof>BMJ (Online), 2014-07, Vol.349 (7971), p.g4731-g4731</ispartof><rights>Mehrabadi et al 2014</rights><rights>Mehrabadi et al 2014.</rights><rights>Copyright BMJ Publishing Group Aug 16, 2014</rights><rights>Copyright BMJ Publishing Group LTD Jul 30, 2014</rights><rights>Mehrabadi et al 2014 2014 Mehrabadi et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b548t-6efcac71cec3af26ce9a1866b8dd3dfd3961a77353683fe6c5e0b06f8dbf0a753</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttp://bmj.com/content/349/bmj.g4731.full.pdf$$EPDF$$P50$$Gbmj$$Hfree_for_read</linktopdf><linktohtml>$$Uhttp://bmj.com/content/349/bmj.g4731.full$$EHTML$$P50$$Gbmj$$Hfree_for_read</linktohtml><link.rule.ids>114,115,230,314,776,780,799,881,3183,23550,27901,27902,30976,57992,58225,77343,77374</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25077825$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mehrabadi, Azar</creatorcontrib><creatorcontrib>Liu, Shiliang</creatorcontrib><creatorcontrib>Bartholomew, Sharon</creatorcontrib><creatorcontrib>Hutcheon, Jennifer A</creatorcontrib><creatorcontrib>Magee, Laura A</creatorcontrib><creatorcontrib>Kramer, Michael S</creatorcontrib><creatorcontrib>Liston, Robert M</creatorcontrib><creatorcontrib>Joseph, K S</creatorcontrib><creatorcontrib>Canadian Perinatal Surveillance System (Public Health Agency of Canada)</creatorcontrib><creatorcontrib>Canadian Perinatal Surveillance System Public Health Agency of Canada</creatorcontrib><creatorcontrib>for the Canadian Perinatal Surveillance System (Public Health Agency of Canada)</creatorcontrib><title>Hypertensive disorders of pregnancy and the recent increase in obstetric acute renal failure in Canada: population based retrospective cohort study</title><title>BMJ (Online)</title><addtitle>BMJ</addtitle><description>Objective To examine whether changes in postpartum haemorrhage, hypertensive disorders of pregnancy, or other risk factors explain the increase in obstetric acute renal failure in Canada.Design Retrospective cohort study.Setting Canada (excluding the province of Quebec).Participants All hospital deliveries from 2003 to 2010 (n=2 193 425).Main outcome measures Obstetric acute renal failure identified by ICD-10 diagnostic codes.Methods Information on all hospital deliveries in Canada (excluding Quebec) between 2003 and 2010 (n=2 193 425) was obtained from the Canadian Institute for Health Information. Temporal trends in obstetric acute renal failure were assessed among women with and without postpartum haemorrhage, hypertensive disorders of pregnancy, or other risk factors. Logistic regression was used to determine if changes in risk factors explained the temporal increase in obstetric acute renal failure.Results Rates of obstetric acute renal failure rose from 1.66 to 2.68 per 10 000 deliveries between 2003-04 and 2009-10 (61% increase, 95% confidence interval 24% to 110%). Adjustment for postpartum haemorrhage, hypertensive disorders, and other factors did not attenuate the increase. The temporal increase in acute renal failure was restricted to deliveries with hypertensive disorders (adjusted increase 95%, 95% confidence interval 38% to 176%), and was especially pronounced among women with gestational hypertension with significant proteinuria (adjusted increase 171%, 71% to 329%). No significant increase occurred among women without hypertensive disorders (adjusted increase 12%, −28 to 72%).Conclusions The increase in obstetric acute renal failure in Canada between 2003 and 2010 was restricted to women with hypertensive disorders and was especially pronounced among women with pre-eclampsia. Further study is required to determine the cause of the increase among women with pre-eclampsia.</description><subject>Acute Kidney Injury - epidemiology</subject><subject>Adult</subject><subject>Blood</subject><subject>Blood transfusions</subject><subject>Canada - epidemiology</subject><subject>Childbirth & labor</subject><subject>Cohort Studies</subject><subject>Delivery, Obstetric</subject><subject>Drugs</subject><subject>Female</subject><subject>Hemorrhage</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Hypertension - epidemiology</subject><subject>Hypertension, Pregnancy-Induced - epidemiology</subject><subject>Kidney diseases</subject><subject>Kidneys</subject><subject>Logistic Models</subject><subject>Medical research</subject><subject>Obstetrics</subject><subject>Postpartum Hemorrhage - epidemiology</subject><subject>Postpartum period</subject><subject>Preeclampsia</subject><subject>Pregnancy</subject><subject>Pregnancy Complications, Cardiovascular - epidemiology</subject><subject>Proteinuria - epidemiology</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Trends</subject><subject>Validation studies</subject><subject>Womens health</subject><issn>0959-8138</issn><issn>1756-1833</issn><issn>0959-8146</issn><issn>1756-1833</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>9YT</sourceid><sourceid>ACMMV</sourceid><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqNkstu1DAUhiMEoqPSBQ8AsgQLWKT4xLGddIGERkCRKrGBdeTYJzMeZexgO5XmOXhhnE4pF4mLN7Z0Pv_n9hfFY6DnAEy86ve7800tGdwrViC5KKFh7H6xoi1vywZYc1KcxbijlFZMNq3gD4uTilMpm4qviq-XhwlDQhftNRJjow8GQyR-IFPAjVNOH4hyhqQtkoAaXSLW6YAqYn4Q38eEKVhNlJ7Tgjg1kkHZcQ43wFo5ZdQFmfw0jypZ70if_5pMpuDjhDotmbXf-pBITLM5PCoeDGqMeHZ7nxaf3739tL4srz6-_7B-c1X2vG5SKXDQSkvQqJkaKqGxVdAI0TfGMDMY1gpQUjLORMMGFJoj7akYGtMPVEnOTovXR91p7vdolt6CGrsp2L0Kh84r2_0acXbbbfx1VwNwISELvLgVCP7LjDF1exs1jqNy6OfYgQAQrM51_Aea95Vp2f4b5RxoBVDXGX32G7rzc8gbyJTMpwUJ7V8pnkusKyFEpl4eKZ3XEgMOd4MA2i1O67LTuhunZfbpz5O7I7_7KgNPjsAuJh9-xAXPLVZLsufH-KL55zzfADy15wE</recordid><startdate>20140730</startdate><enddate>20140730</enddate><creator>Mehrabadi, Azar</creator><creator>Liu, Shiliang</creator><creator>Bartholomew, Sharon</creator><creator>Hutcheon, Jennifer A</creator><creator>Magee, Laura A</creator><creator>Kramer, Michael S</creator><creator>Liston, Robert M</creator><creator>Joseph, K S</creator><general>British Medical Journal Publishing Group</general><general>BMJ Publishing Group</general><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group Ltd</general><scope>9YT</scope><scope>ACMMV</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88I</scope><scope>8AF</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ASE</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FPQ</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K6X</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M2O</scope><scope>M2P</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><scope>7U1</scope><scope>7U2</scope><scope>C1K</scope><scope>5PM</scope></search><sort><creationdate>20140730</creationdate><title>Hypertensive disorders of pregnancy and the recent increase in obstetric acute renal failure in Canada: population based retrospective cohort study</title><author>Mehrabadi, Azar ; Liu, Shiliang ; Bartholomew, Sharon ; Hutcheon, Jennifer A ; Magee, Laura A ; Kramer, Michael S ; Liston, Robert M ; Joseph, K S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b548t-6efcac71cec3af26ce9a1866b8dd3dfd3961a77353683fe6c5e0b06f8dbf0a753</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Acute Kidney Injury - epidemiology</topic><topic>Adult</topic><topic>Blood</topic><topic>Blood transfusions</topic><topic>Canada - epidemiology</topic><topic>Childbirth & labor</topic><topic>Cohort Studies</topic><topic>Delivery, Obstetric</topic><topic>Drugs</topic><topic>Female</topic><topic>Hemorrhage</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Hypertension - epidemiology</topic><topic>Hypertension, Pregnancy-Induced - epidemiology</topic><topic>Kidney diseases</topic><topic>Kidneys</topic><topic>Logistic Models</topic><topic>Medical research</topic><topic>Obstetrics</topic><topic>Postpartum Hemorrhage - epidemiology</topic><topic>Postpartum period</topic><topic>Preeclampsia</topic><topic>Pregnancy</topic><topic>Pregnancy Complications, Cardiovascular - epidemiology</topic><topic>Proteinuria - epidemiology</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Trends</topic><topic>Validation studies</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mehrabadi, Azar</creatorcontrib><creatorcontrib>Liu, Shiliang</creatorcontrib><creatorcontrib>Bartholomew, Sharon</creatorcontrib><creatorcontrib>Hutcheon, Jennifer A</creatorcontrib><creatorcontrib>Magee, Laura A</creatorcontrib><creatorcontrib>Kramer, Michael S</creatorcontrib><creatorcontrib>Liston, Robert M</creatorcontrib><creatorcontrib>Joseph, K S</creatorcontrib><creatorcontrib>Canadian Perinatal Surveillance System (Public Health Agency of Canada)</creatorcontrib><creatorcontrib>Canadian Perinatal Surveillance System Public Health Agency of Canada</creatorcontrib><creatorcontrib>for the Canadian Perinatal Surveillance System (Public Health Agency of Canada)</creatorcontrib><collection>BMJ Open Access Journals</collection><collection>BMJ Journals:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Index</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Research Library</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>Risk Abstracts</collection><collection>Safety Science and Risk</collection><collection>Environmental Sciences and Pollution Management</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMJ (Online)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mehrabadi, Azar</au><au>Liu, Shiliang</au><au>Bartholomew, Sharon</au><au>Hutcheon, Jennifer A</au><au>Magee, Laura A</au><au>Kramer, Michael S</au><au>Liston, Robert M</au><au>Joseph, K S</au><aucorp>Canadian Perinatal Surveillance System (Public Health Agency of Canada)</aucorp><aucorp>Canadian Perinatal Surveillance System Public Health Agency of Canada</aucorp><aucorp>for the Canadian Perinatal Surveillance System (Public Health Agency of Canada)</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Hypertensive disorders of pregnancy and the recent increase in obstetric acute renal failure in Canada: population based retrospective cohort study</atitle><jtitle>BMJ (Online)</jtitle><addtitle>BMJ</addtitle><date>2014-07-30</date><risdate>2014</risdate><volume>349</volume><issue>7971</issue><spage>g4731</spage><epage>g4731</epage><pages>g4731-g4731</pages><issn>0959-8138</issn><issn>1756-1833</issn><issn>0959-8146</issn><eissn>1756-1833</eissn><coden>BMJOAE</coden><abstract>Objective To examine whether changes in postpartum haemorrhage, hypertensive disorders of pregnancy, or other risk factors explain the increase in obstetric acute renal failure in Canada.Design Retrospective cohort study.Setting Canada (excluding the province of Quebec).Participants All hospital deliveries from 2003 to 2010 (n=2 193 425).Main outcome measures Obstetric acute renal failure identified by ICD-10 diagnostic codes.Methods Information on all hospital deliveries in Canada (excluding Quebec) between 2003 and 2010 (n=2 193 425) was obtained from the Canadian Institute for Health Information. Temporal trends in obstetric acute renal failure were assessed among women with and without postpartum haemorrhage, hypertensive disorders of pregnancy, or other risk factors. Logistic regression was used to determine if changes in risk factors explained the temporal increase in obstetric acute renal failure.Results Rates of obstetric acute renal failure rose from 1.66 to 2.68 per 10 000 deliveries between 2003-04 and 2009-10 (61% increase, 95% confidence interval 24% to 110%). Adjustment for postpartum haemorrhage, hypertensive disorders, and other factors did not attenuate the increase. The temporal increase in acute renal failure was restricted to deliveries with hypertensive disorders (adjusted increase 95%, 95% confidence interval 38% to 176%), and was especially pronounced among women with gestational hypertension with significant proteinuria (adjusted increase 171%, 71% to 329%). No significant increase occurred among women without hypertensive disorders (adjusted increase 12%, −28 to 72%).Conclusions The increase in obstetric acute renal failure in Canada between 2003 and 2010 was restricted to women with hypertensive disorders and was especially pronounced among women with pre-eclampsia. Further study is required to determine the cause of the increase among women with pre-eclampsia.</abstract><cop>England</cop><pub>British Medical Journal Publishing Group</pub><pmid>25077825</pmid><doi>10.1136/bmj.g4731</doi><tpages>1</tpages><edition>International edition</edition><oa>free_for_read</oa></addata></record> |
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| source | Applied Social Sciences Index & Abstracts (ASSIA); Jstor Complete Legacy; MEDLINE; BMJ Journals - NESLi2 |
| subjects | Acute Kidney Injury - epidemiology Adult Blood Blood transfusions Canada - epidemiology Childbirth & labor Cohort Studies Delivery, Obstetric Drugs Female Hemorrhage Hospitals Humans Hypertension Hypertension - epidemiology Hypertension, Pregnancy-Induced - epidemiology Kidney diseases Kidneys Logistic Models Medical research Obstetrics Postpartum Hemorrhage - epidemiology Postpartum period Preeclampsia Pregnancy Pregnancy Complications, Cardiovascular - epidemiology Proteinuria - epidemiology Retrospective Studies Risk Factors Trends Validation studies Womens health |
| title | Hypertensive disorders of pregnancy and the recent increase in obstetric acute renal failure in Canada: population based retrospective cohort study |
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