Abstract: SA-PO1063
Maternal Kidney Disease and Offspring Neurodevelopmental Outcomes: A Nationwide Population-Based Study
Session Information
- Women's Health and Kidney Diseases
October 26, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Women's Health and Kidney Diseases
- 2200 Women's Health and Kidney Diseases
Authors
- Song, Jeongin, Dongguk University Medical Center, Goyang, Gyeonggi, Korea (the Republic of)
- Han, Seung hyun, Seoul National University Seoul Metropolitan Government Boramae Medical Center, Dongjak-gu, Seoul, Korea (the Republic of)
- Park, Sehoon, Seoul National University Hospital Department of Internal Medicine, Jongno-gu, Seoul, Korea (the Republic of)
- Lee, Hajeong, Seoul National University Hospital Department of Internal Medicine, Jongno-gu, Seoul, Korea (the Republic of)
Background
Maternal immune activation, triggered by both acute and systemic chronic inflammation, is considered a predisposing factor for offspring neurodevelopmental conditions. However, there is no data about the effect of mothers’ chronic kidney disease on their offspring’s neurodevelopmental diseases.
Methods
We extracted the data on pregnant women from the National Health Information Database from 2008 to 2017 in South Korea. We categorized the subjects into four groups based on their pre-pregnancy kidney function: no CKD, CKD, kidney replacement therapy (KRT), and kidney transplantation (KT). The outcomes are defined as offspring's neurodevelopmental diseases, including motor and cognitive developmental delay, autism spectrum disorders, attention deficit hyperactivity disorder, tics, stereotypic behavior, and seizures based on ICD-10-CM codes.
Results
A total of 3,794,031 children were born to 2,680,092 mothers during the study period. We included 488,208 mothers without kidney diseases, 46,930 mothers with CKD, 49 mothers with ESKD, 187 mothers with KT, and 3,637,903 children after the exclusion of multiple pregnancies. Mothers with CKD, KRT, and KT had older ages and more co-morbidities than those without. They suffered from more adverse pregnancy outcomes, such as preeclampsia, preterm birth, and placenta previa/abruption. Their offspring’s neurodevelopmental disease occurred in 8.7%, 10.9%, 31.7%, and 16.3% of the no CKD, CKD, KRT, and KT groups, respectively. Mothers with CKD (adjusted OR [95% CI]: 1.29 [1.26-1.33], p<0.001), KT (1.87 [1.28-2.65], p=0.001), and ESKD (3.73 [2.12-6.37], p<0.001) showed a higher risk of offspring’s neurodevelopmental diseases even after adjusting for maternal age, nulliparity, underlying hypertension, smoking history, maternal BMI, gestational diabetes, preeclampsia, neonatal sex, preterm birth, and low birth weight.
Conclusion
In this nationwide cohort study, we first found that maternal pre-pregnancy kidney function was associated with offspring’s adverse neurodevelopmental diseases in dose-responsive manners.