OP 48 Metabolic and hypertensive complications of pregnancy in women with nephrolithiasis

Abstract

Introduction Kidney stones are associated with future development of hypertension, diabetes and the metabolic syndrome. The relationship between nephrolithiasis and pregnancy complications, including gestational dysglycemia and hypertension, has not previously been evaluated. Objectives We sought to assess whether kidney stone formation prior to pregnancy was associated with metabolic and hypertensive complications in pregnancy. We hypothesized that stone formation is a marker of metabolic disease and would be associated with maternal complications in pregnancy. Patients and methods We conducted a retrospective cohort study of women who received prenatal care and delivered infants at Massachusetts General Hospital from 2011 to 2016. Women with abdominal imaging (CT or ultrasound) prior to pregnancy were included in the analysis.Women with chronic kidney disease, hypertension and diabetes were excluded. Pregnancy outcomes of women with documented kidney stones on imaging (stone formers, n = 79) were compared to women without stones on imaging (controls, n = 642). We performed a stratified analysis of pregnancy outcomes in women with high (>25 kg/m2) vs. normal (⩽25 kg/m2) BMI in the first trimester. Results Mean glucose levels after a 50-gram glucose challenge were higher in stone formers (127 ± 29 mg/dl vs. 118 ± 27 mg/dl, p = 0.02) despite similar baseline body mass index (27.3 ± 5.5 kg/m2 vs. 27.6 ± 6.4 kg/m2, p = 0.62). Rates of hypertensive disorders of pregnancy were higher in stone formers (16% vs 6%, p Conclusion In women without preexisting diabetes and hypertension, a history of nephrolithiasis was associated with gestational dysglycemia and hypertensive disorders of pregnancy, especially in women with high first trimester BMI. Nephrolithiasis may be a marker of increased metabolic risk in women without traditional risk factors for pregnancy complications.