TOPLINE:

The presence of acute kidney injury (AKI) during pregnancy was associated with a higher risk for adverse cardiovascular and renal outcomes.

METHODOLOGY:

• Researchers conducted a systematic review and meta-analysis to quantify the risk for adverse cardiovascular and renal outcomes following AKI during pregnancy.
• They performed a literature search across various databases and identified 17 studies including 50,285,836 pregnant women, of whom 36,806 were affected by AKI.
• Risks for adverse cardiovascular and renal outcomes in pregnant women following AKI were evaluated using a random-effects meta-analysis.

TAKEAWAY:

• AKI during pregnancy was associated with a 52-fold higher risk for composite adverse renal outcomes (odds ratio [OR], 52.37; 95% CI, 4.67-587.63; eight studies) and a 38-fold higher risk for prolonged renal insufficiency (OR, 38.07; 95% CI, 10.29-140.82; five studies) than no AKI during pregnancy.
• Women with AKI during pregnancy had a 23-fold higher risk for stroke (OR, 22.92; 95% CI, 2.32-226.65; three studies) and a 22-fold higher risk for heart failure (OR, 22.55; 95% CI, 4.39-115.71; three studies) than those without AKI during pregnancy.
• The risk for ICU admission and maternal mortality was 3.9-fold higher (OR, 3.86; 95% CI, 1.93-7.71; three studies) and 9.3-fold higher (OR, 9.26; 95% CI, 2.52-33.96; 12 studies) in women with AKI during pregnancy, respectively, than in those without.

IN PRACTICE:

"Our study highlights the importance of AKI in pregnancy as a risk factor for significant future adverse cardiovascular and renal outcomes. As a common renal problem in pregnancy, it is crucial to ensure women who sustain AKI in pregnancy are followed up and monitored appropriately," the authors wrote.

SOURCE:

This study was led by Deepthika Jeyaraman, Academic Department of Obstetrics and Gynaecology, University Hospitals of North Midlands, Stoke-on-Trent, England. It was published online on September 24, 2025, in BJOG: An International Journal of Obstetrics & Gynaecology.

LIMITATIONS:

This study was limited by publication bias and the exclusion of non-English and grey literature. The retrospective nature of some included studies limited control over the quality of data. High heterogeneity between studies may have resulted from differences in study populations, methodology, study period, and country of origin and inherent differences between the studies.

DISCLOSURES:

Jeyaraman reported receiving funding from the National Institute for Health and Care Research Integrated Academic Training Programme. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.