Authors: Kyle Spradling, Chiyuan Zhang, Alan Pao, Joseph Liao, John Leppert, Christopher Elliott, Simon ContiIntroduction: Urinary stone disease during pregnancy is a clinical challenge and is associated with fetal and maternal morbidity. While several physiologic changes during pregnancy are thought to increase the risk of developing stone disease, it is unclear if women with urinary stone disease during pregnancy are at risk for recurrent urinary stone disease after pregnancy. We aimed to determine the risk of postpartum urinary stone disease in women with a history of stone disease during pregnancy.
Methods: Using the Optum® de-identified Clinformatics© Datamart we identified pregnant women with urinary stone disease in the United States between January 2003 to December 2017 by standardized ICD-9, ICD-10, and CPT code criteria. We limited the cohort to include women without evidence of urinary stone disease prior to pregnancy. We abstracted patient demographic characteristics, clinical risk factors for stone disease, and data for urinary stone disease encounters and related procedures after pregnancy. Encounters occurring within 1 year of pregnancy were excluded. Cox proportional hazard models were used to analyze for significance.
Results: We identified a total of 1,395,783 pregnant women with a median postpartum follow-up of 4.0 years, including 5,971 (0.4%) women diagnosed with a urinary stone during pregnancy. Of these, 736 (10.5%) had an additional urinary stone diagnosis claim after pregnancy, compared with 13,275 (0.95%) women without a history of stone disease during pregnancy (p < 0.0001). In multivariable proportional hazards models urinary stone disease during pregnancy (HR 12.8, 95% CI [11.8 – 13.8]) was independently associated with a higher hazard of urinary stone disease after pregnancy (Figure 1).
Conclusions: Women urinary stone disease during pregnancy have an increased risk of developing urinary stone disease after pregnancy. Given the 1 in 10 chance of needing further care, women with history of stone disease during pregnancy may benefit from risk counseling, surveillance, or secondary prevention efforts in the postpartum period.
Source of Funding: No funding source to declare.