Effect of HELLP syndrome on acute kidney injury in pregnancy and pregnancy outcomes: a systematic review and meta-analysis

Qiang Liu,Guan-Jun Ling,Shao-Quan Zhang,Yi-Juan Chen,Wen-Qing Zhai

doi:10.1186/s12884-020-03346-4

Qiang Liu, Guan-Jun Ling + Show 3 more

Open Access

https://doi.org/10.1186/s12884-020-03346-4

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Abstract

BackgroundHELLP syndrome may increase adverse pregnancy outcomes, though the incidence of it is not high. At present, the impact of HELLP syndrome on P-AKI (acute kidney injury during pregnancy) and maternal and infant outcomes is controversial. Thus, we conducted a meta-analysis to find out more about the relationship between HELLP syndrome and P-AKI and pregnancy outcomes.MethodsWe systematically searched PubMed, Embassy and Cochrane Databases for cohort studies and RCT to assess the effect of HELLP syndrome on P-AKI and maternal and infant outcomes. Study-specific risk estimates were combined by using fixed-effect or random-effect models.ResultsThis meta-analysis included 11 cohort studies with a total of 6333 Participants, including 355 cases of pregnant women with HELLP syndrome and 5979 cases that without. HELLP syndrome was associated with relatively higher risk of P-AKI (OR4.87 95% CI 3.31 ~ 7.17, P<0.001), fetal mortality (OR1.56 95% CI 1.45 ~ 2.11, P<0.001) and Maternal death (OR3.70 95% CI 1.72 ~ 7.99, P<0.001).ConclusionsHELLP syndrome is associated with relatively higher risk of P-AKI, fetal mortality and maternal death.

Highlights

HELLP syndrome may increase adverse pregnancy outcomes, though the incidence of it is not high
Up to 500,000 pregnant women die every year due to complications related to preeclampsia [1]
HELLP syndrome was defined by Weistein in 1982 as a clinical manifestation of elevated liver enzymes, hemolysis, and thrombocytopenia [2]

Summary

Introduction

HELLP syndrome may increase adverse pregnancy outcomes, though the incidence of it is not high. The impact of HELLP syndrome on P-AKI (acute kidney injury during pregnancy) and maternal and infant outcomes is controversial. HELLP syndrome is a serious pregnancy complication that can threaten the safety of the mother and fetus. In patients with HELLP syndrome, acute kidney injury is a common cause of maternal and fetal death. For pregnant women,acute kidney injury can lead to anuria, heart failure, and severe pulmonary edema [6]. These complications can bring about rapid death of pregnant women and fetuses. The relationship between HELLP syndrome and acute kidney injury in pregnancy

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