Dr Ali Khashan of Cork University Maternity Hospital (CUMH). (Pic: Diane Cusack)

Women with pre-eclampsia during pregnancy have a five-fold increased risk of end-stage kidney disease (ESKD) later in life compared to women who don’t develop pre-eclampsia during pregnancy, according to a new study. 

The study by Dr Ali Khashan, UCC, and colleagues at the Karolinska Institute, Sweden and Liverpool University, UK, was published this week in PLOS Medicine. 

"This research demonstrates that again, complicated pregnancies may have long-standing adverse effects on maternal health. Pre-eclampsia increases the risk of end-stage kidney disease in mothers, however, the risk remains small. Future research needs to focus on modifiable risk factors and how we may monitor and screen women after complicated pregnancies to reduce these long-term risks and improve long term health," said Dr Ali Khashan, Public Health and Epidemiology and INFANT, UCC.

As the prevalence of kidney disease has risen over recent years, it has become clear that more women have pre-dialysis kidney disease than men. Reproductive history, including the development of pre-eclampsia during pregnancy, has been hypothesized to play a role.

In the new study, researchers analysed data from the Swedish Medical Birth Register on 1,366,441 healthy women with 2,665,320 singleton live births in Sweden between 1982 and 2012.

The data revealed that women who had pre-eclampsia in at least one pregnancy were nearly five times more likely to have ESKD than women who had never had pre-eclampsia (hazard ratio 4.96; 95%CI 3.89–6.32).

The incidence rate of ESKD per 100,000 person-years was 1.85 (95%CI 1.66–2.05) among women with no history of pre-eclampsia and 12.35 (95%CI 9.61–15.88) among women with a history of pre-eclampsia.

Moreover, the association was independent of other factors including maternal age and education, and diagnoses of renal disease or cardiovascular disease before pregnancy.

The new paper “shows that pre-eclampsia is a sex-specific, independent risk factor for the subsequent development of ESKD,” the authors say. “However, it should be noted that the overall ESKD risk remains small. Whether screening or preventative strategies will reduce the risk of ESKD in women with adverse pregnancy outcomes is worthy of further investigation.”

The study was partly funded by INFANT, the Strategic Research Programme in Diabetes at Karolinska Institutet, the Stockholm County Council and the Swedish Kidney Foundation.