Introduction:
Pregnancy-Related Acute Kidney Injury (PRAKI) is a critical condition associated with significant maternal and fetal morbidity and mortality. Dyslipidemia is a recognized risk factor for adverse pregnancy outcomes, but its relationship with PRAKI is underexplored.
The aim of this study is to evaluate the association between dyslipidemia and adverse maternal and fetal outcomes in pregnant women diagnosed with Pregnancy-Related Acute Kidney Injury (PRAKI). This study seeks to explore how elevated lipid levels correlate with complications such as preeclampsia, preterm labor, and small-for-gestational-age (SGA).
Methods:
This observational study conducted in a tertiary care hospital, included 100 pregnant women diagnosed with PRAKI beyond 20 weeks of gestation. Lipid profiles, including total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL), and very-low-density lipoprotein (VLDL), were measured using fasting blood samples, at the time of diagnosis of PRAKI. Patients with multiple pregnancies, diabetes mellitus, coronary artery disease, and known case of dyslipidemia were excluded. Written and informed consents were taken from all patients enrolled in the study. Institutional ethical committee approval was obtained. Statistical analyses were performed using SPSS software.
Results:
The mean age of the patients was 27.8 ± 4.1 years, with a mean pre-pregnancy BMI of 20.2 ± 2.4 kg/m². Elevated lipid levels were noted: mean TC was 310 ± 30 mg/dL, TG 260 ± 22 mg/dL, LDL 135 ± 12 mg/dL, and VLDL 62 ± 4 mg/dL Preeclampsia was observed in 60.3% of the dyslipidemic group (35 out of 58 patients) compared to 28.6% of the non-dyslipidemic group (12 out of 42 patients) (p < 0.01), indicating a statistically significant association between dyslipidemia and preeclampsia in PRAKI patients. Preterm labor occurred in 74.1% of the dyslipidemic group (43 out of 58 patients) compared to 52.4% of the non-dyslipidemic group (22 out of 42 patients) (p < 0.05), showing a significant association between lipid derangements and preterm labor. Fetal deaths were noted in 77.6% of the dyslipidemic group (45 out of 58 patients) compared to 61.9% of the non-dyslipidemic group (26 out of 42 patients) (p < 0.05). Among the fetal deaths, 73.2% were intrauterine deaths (IUD), and 26.8% were stillbirths. Among live births, 20.6% of the infants were small-for-gestational-age (SGA), predominantly in the dyslipidemic group, with a statistically significant difference compared to the non-dyslipidemic group (p < 0.05). Of the cohort, 53% cases were unbooked, and nine patients succumbed to complications, resulting in a 9% mortality rate. None of them had pancreatitis. By 12 weeks postpartum, all the patients' lipid profiles had returned to normal levels.
Conclusions:
Dyslipidemia in PRAKI patients is associated with adverse pregnancy outcomes such as preeclampsia, preterm labour, small-for-gestational-age (SGA) and fetal deaths. The high rate of unbooked cases 53% and late referrals to our center underscores the challenges in managing severe cases of PRAKI, which remain difficult for both maternal and neonatal care. There are currently no established guidelines for managing dyslipidemia in patients with pregnancy-related acute kidney injury (PRAKI) during pregnancy and the immediate postpartum period. Therefore, it is recommended that lipid profile screening has to be conducted at the time of conception and closely monitored throughout pregnancy and postpartum to prevent potential complications.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.