Correlative Findings of Maternal and Placental Health with Congenital Heart Disease and Post-Operative Acute Kidney Injury




George, Ann
Hamby, Tyler
Lanier, Lane


0000-0001-9510-5013 (George, Ann)
0000-0001-7850-889X (Lanier, Lane)

Journal Title

Journal ISSN

Volume Title



Purpose: Acute kidney injury (AKI) is a common complication in pediatric patients with congenital heart disease (CHD) who undergo cardiopulmonary bypass (CPB). Besides established risk factors such as time on CPB, factors affecting fetal development may contribute to the prevalence of AKI within this population. Adverse intrauterine microenvironments associated with certain maternal conditions have been shown to impact nephrogenesis. These factors also increase the risk of preterm delivery, shortening the timeframe for nephrogenesis. Thus, infants that develop in these microenvironments may be predisposed to develop AKI when subjected to secondary insults such as CPB. This study aims to examine the incidence of AKI in this patient population and determine whether maternal or fetal variables predict the development of AKI. Methods: Retrospective review of electronic medical records of pediatric patients at Cook Children’s Medical Center (CCMC) between 3/1/2022 and 4/14/2022. Inclusion criteria were as follows: patients aged 0-12 months who underwent surgical repair or palliation of CHD with care in the cardiac intensive care unit (CICU). Data collected included maternal variables such as pre-eclampsia, gestational diabetes, obesity, and smoking status; individual variables such as gestational age and other congenital factors; and surgical variables such as CPB time and average PAO2 during CPB. AKI was determined using creatinine levels from established Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Results: Twenty patients met inclusion criteria. No statistical significance was noted between maternal and surgical variables. Twenty percent of patients developed at least Stage 1 AKI. Conclusions: Identification of maternal risk factors for AKI in the pediatric population may allow further insight into the mechanisms of the development of AKI. Our results were impacted by the low power of our study. Inclusion of more patients into our study will positively impact our power.