title: Renal function during pregnancy may predict risk of future hospitalization due to atherosclerotic-related morbidity.
abstract: OBJECTIVE
  This study aims to examine whether renal function during pregnancy can serve as a surrogate marker for the risk of developing atherosclerotic-related morbidity.
  
  
  METHODS
  A case-control study, including women who gave birth at a tertiary referral medical centre during 2000-2012. This population was divided into cases of women who were subsequently hospitalized for atherosclerotic morbidity during the study period and age-matched controls. From the study population, we retrieved two groups: the creatinine (Cr) group: women who had at least one Cr measurement (4945 women) and the urea group: women who had at least one urea measurement (4932 women) during their pregnancies. In the Cr and urea group, there were 572 and 571 cases and 4373 and 4361 controls, respectively. The mean follow-up period in the Cr and urea group was 61.7 ± 37.0 and 57.3 ± 36.0 months, respectively. Cox proportional hazards models (controlling for confounders: gestational hypertension, gestational diabetes, obesity, maternal age, creatinine level (for urea), and gestational week) were used to estimate the adjusted hazard ratios (HR) for hospitalizations.
  
  
  RESULTS
  A significant association was documented between renal function during pregnancy and long-term atherosclerotic morbidity. Multivariate analysis, showed that Cr at pregnancy index of ≥89 μmol/L was associated with a significant increased risk for hospitalization due to cardiovascular (CVS) events (adjusted HR = 2.91 CI 1.37-6.19 P = 0.005) and urea level ≤7 mmol/L was independently associated with reduced prevalence of CVS hospitalization (adjusted HR = 0.62 CI 0.57-0.86 P = 0.001).
  
  
  CONCLUSIONS
  Renal function abnormality during pregnancy may reveal occult predisposition to atherosclerotic morbidity years after childbirth.
authors.affiliation: Hypertension Unit, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Talya
authors.initials: T
authors.lastname: Wolak
authors.affiliation: Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Ilana
authors.initials: I
authors.lastname: Shoham-Vardi
authors.affiliation: Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Ruslan
authors.initials: R
authors.lastname: Sergienko
authors.affiliation: Department of Obstetrics and Gynecology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
authors.forename: Eyal
authors.initials: E
authors.lastname: Sheiner
mesh_terms: D000328:Adult; D050197:Atherosclerosis / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D015415:Biomarkers / Q000378:metabolism; D016009:Chi-Square Distribution; D003404:Creatinine / Q000378:metabolism; D005260:Female; D006760:Hospitalization; D006801:Humans; D007557:Israel / Q000453:epidemiology; D007668:Kidney / Q000378:metabolism / Q000503:physiopathology*; D007677:Kidney Function Tests; D016014:Linear Models; D015999:Multivariate Analysis; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000378:metabolism / Q000503:physiopathology*; D015995:Prevalence; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D062606:Tertiary Care Centers; D013997:Time Factors; D014508:Urea / Q000378:metabolism
chemical_list: D015415:Biomarkers; D014508:Urea; D003404:Creatinine
keywords: atherosclerosis; creatinine; pregnancy; renal function; urea