Pregestational and Gestational Diabetes Raise Postpartum Kidney Disease Risk: Study
Researchers have found that women with pregestational diabetes mellitus (PGDM) face a dramatically higher risk of postpartum kidney disease, and those with gestational diabetes mellitus (GDM) also experience elevated, though more modest, risks. This study was published in Diabetes Research and Clinical Practice journal by Amy Backal and colleagues.
Rates of PGDM and GDM have increased worldwide. Although their effects on fetal and maternal outcome during pregnancy are established, their effect on maternal renal health post-delivery is less understood. The risk of hospital readmission for kidney complications, acute kidney injury (AKI) and chronic kidney disease (CKD), in the same calendar year as delivery was explored in this study.
Methods
The Nationwide Readmissions Database from the years 2010 to 2020 provided data for this research. The population was women aged 15 to 54 years who delivered over this time and did not have a previous history of kidney disease. The participants were classified into three groups: individuals with PGDM, which was a previous diagnosis of diabetes prior to pregnancy; individuals with GDM, which was a new diagnosis during pregnancy; and a comparison group of women with no kind of diabetes.
The response outcomes measured were readmissions to the hospital due to AKI or CKD within the same year of giving birth. Cox regression models incorporating confounding factors such as maternal age, race, co-existing medical conditions, and complications that arose during giving birth were used to analyze the data.
Key Findings
Pregestational Diabetes (PGDM):
Risk of AKI was 9-fold higher: adjusted HR = 9.07 (95% CI: 8.44–9.75)
Risk of CKD was ~21-fold higher: adjusted HR = 20.73 (95% CI: 18.00–23.87)
Gestational Diabetes (GDM):
AKI risk was elevated 25%: adjusted HR = 1.25 (95% CI: 1.16–1.35)
CKD risk was elevated 34%: adjusted HR = 1.34 (95% CI: 1.14–1.58)
These findings highlight a substantially elevated risk of postpartum kidney disease in women with pregestational and gestational diabetes. Interventions and monitoring policies addressed to kidney function in the postpartum period are mandatory to minimize morbidity and long-term complications in this expanding high-risk group.
Reference:
Backal, A., Vasudevan, S., Lee, R., Rosenfeld, E. B., & Ananth, C. V. (2025). Pregestational and gestational diabetes mellitus and risk of postpartum kidney disease: A retrospective cohort study. Diabetes Research and Clinical Practice, 226(112330), 112330. https://doi.org/10.1016/j.diabres.2025.112330
