Increased risk of adverse maternal and infant outcomes among women with renal disease.

We conducted a retrospective population-based study to estimate the risk of adverse maternal and neonatal outcomes in women with a diagnosis of renal disease during pregnancy. One hundred and sixty-nine women with renal disease who gave birth to a singleton infant between 1987 and 1993 were identified through linked Washington State hospital discharge and birth certificate databases. For comparison, 506 women without renal disease matched for year of delivery were selected. Women with renal disease were at increased risk of pre-eclampsia [OR = 7.2, 95% CI 4.2-12.5], preterm labour [OR = 7.9, 95% CI 1.9-32.6], dysfunctional labour [OR = 3.6, 95% CI 1.1-11.5], and caesarean section [OR = 3.1, 95% CI 2.0-4.8]. They were also at increased risk of delivering infants who were small for gestational age [OR = 5.3, 95% CI 2.8-10.0], preterm [OR = 6.1, 95% CI 3.3-11.3], and had 5-minute Apgar scores of less than 7 [OR = 3.9, 95% CI 1.1-14.6]. These associations persisted in analyses restricted to women without chronic hypertension. Women with renal disease and their infants also had median hospital charges that were more than twice those of women without renal disease and were more likely to be hospitalised longer. These data demonstrate that, independent of chronic hypertension, women with underlying renal disease are at increased risk of adverse maternal and perinatal outcomes and use more resources than women without renal disease.