(HealthDay News) — Increased levels of prepregnancy serum creatinine are associated with an increased risk for preterm birth, according to a study published in CMAJ, the journal of the Canadian Medical Association.

Ziv Harel, MD, from St. Michael’s Hospital in Toronto, and colleagues conducted a population-based cohort study involving women aged 16 to 50 years with a singleton birth between 2006 and 2016 and measurements of serum creatinine within 10 weeks preceding their estimated date of conception. The association of prepregnancy kidney dysfunction, measured using serum creatinine cut points, with preterm birth (23 to 36 weeks of gestation) was examined among 55,946 pregnancies.

The researchers found that preterm birth before 37 weeks of gestation occurred in 7.1% of women. Compared with those with prepregnancy creatinine at or below the 95th percentile, women with prepregnancy creatinine above the 95th percentile had an increased risk for preterm birth before 37 weeks (9.1 vs 7.0%; adjusted relative risk [RR], 1.23; 95% confidence interval [CI], 1.09 to 1.38). The association was significant for provider-initiated preterm birth (adjusted RR, 1.30; 95% CI, 1.11 to 1.52), but not for spontaneous preterm birth (adjusted RR, 1.12; 95% CI, 0.91 to 1.37).

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“The current findings underscore the importance of prepregnancy kidney dysfunction for key perinatal outcomes,” the authors write. “The timely recognition of prepregnancy kidney dysfunction has several potential benefits, including informed counselling about the risk of adverse perinatal outcomes, closer monitoring of mother and fetus in pregnancy and potential use of acetylsalicylic acid to prevent preeclampsia.”

One author disclosed financial ties to the biopharmaceutical and medical technology industries.


Harel Z, Park AL, McArthur E, et al. Prepregnancy renal function and risk of preterm birth and related outcomes. CMAJ July 27, 2020 192(30)E851-E857. doi: 10.1503/cmaj.200089