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Abstract

Abstract Objective : The pregnancy, delivery and neonatal outcomes of pregnancies complicated by polycystic kidney disease have yet to be investigated in a population-based study. Most available research consists of case reports or case-control studies limited by small population sizes. 11-13 We sought to evaluate the obstetric and neonatal outcomes in pregnant patients with polycystic kidney disease using a national population database. Methods : This is a retrospective population-based cohort study utilizing the Healthcare Cost and Utilization Project, Nationwide Inpatient Sample (HCUP-NIS). All women who delivered or had a maternal death (2004–2014 inclusive) were included in the study. Pregnancy, delivery, and neonatal outcomes were compared between women with an ICD-9 diagnosis of polycystic kidney disease to those without. While this paper uses the term “women” to reflect the framing of the original data set, we wish to acknowledge the distinction between biological sex, the ability to carry a child, and gender identity. Results : In total, 9,096,788 women met the inclusion criteria. Of these, 1690 (18.6/100000) had polycystic kidney disease (PKD), and the rest acted as controls. Patients with PKD, compared to those without, were more likely to be older ( P =0.0001), Caucasian ( P =0.0001), and to use private medical insurance plans ( P =0.0001). Patients with PKD were also more likely to be obese ( P =0.0001), to have chronic hypertension ( P =0.0001), and thyroid disease ( P =0.0001). When controlling for confounding effects, patients with PKD, compared to those without, were more likely to develop pregnancy induced hypertension (aOR 2.81 [95% CI 2.48,-3.19], P = 0.0001), gestational hypertension (aOR 2.20 [95% CI 1.77-2.73], P = 0.0001), preeclampsia (aOR 2.95 [95% CI 2.45-3.56], P = 0.0001), preeclampsia or eclampsia superimposed on pre-existing hypertension (aOR 2.62 [95% CI 2.10-3.26], P = 0.0001), to experience preterm delivery (aOR 1.51 [95% CI 1.29,-1.76], P =0.0001). Babies born to mothers having PKD were at a higher incidence of being born small for gestational age (aOR 1.45 [95% CI 1.13-1.86], P = 0.0001). Conclusions : PKD was associated with many pregnancy complications, including hypertensive disorders and neonatal complications. Pregnancy monitoring should be tailored to these issues and patients with PKD should be informed of warning signs.