PP038. Are women with gestational hypertension or preeclampsia at an increased long term risk of kidney function impairment?

INTRODUCTION

Preeclampsia is known to cause impairment of kidney function in pregnancy, which manifests as proteinuria. Previous studies have found an association between preeclampsia and kidney disease but were restricted in their numbers or had a short follow up time.

OBJECTIVES

To assess the long term effects of hypertensive disorders of pregnancy on kidney function in later life.

METHODS

From the Aberdeen maternity and neonatal databank (AMND), we identified the first singleton pregnancy of all women with date of birth on or before 30th June 1969. These women were linked by means of their identifying information to the local renal biochemistry database (GRBD). GRBD captures all kidney function tests from primary and secondary care in the health region. A cohort study design was used to assess the odds ratios with 95% confidence intervals for chronic kidney disease stage 1-5 (predefined based on internationally accepted KDOQI definition) occurring at least 1year following delivery. Those with gestational hypertension and preeclampsia were compared to normotensive women using multivariate logistic regression to adjust for potential confounders.

RESULTS

A total of 14675 women who had been linked to the RBD and had complete information regarding age, socio-economic class, smoking category, and body mass index (BMI) were included in a multivariate model. The unadjusted odds ratio (95% confidence interval) of having chronic kidney disease (according to previously stated definition) in preeclamptic women was 2.04 (1.53,2.71) and that in women with gestational hypertension was 1.37 (1.15,1.65), while the adjusted odds ratio (95% confidence interval) of having chronic kidney disease was 1.93 (1.44,2.57) and 1.36 (1.13,1.63) in preeclamptic women and women with gestational hypertension respectively compared to women who were normotensive in their first pregnancy.

CONCLUSION

Women who had gestational hypertension or preeclampsia in their first pregnancy had a higher risk of impairment of renal function compared to women who were normotensive.

Determinants of quality of life of elderly Nigerians: results from the Ibadan study of ageing

Little is known about factors that determine the QoL of elderly persons living in developing societies undergoing rapid social changes. A representative sample of elderly Nigerians, aged 65 years and over (n = 2152), was assessed for QoL using the World Health Organization Quality of Life instrument (WHOQoL-Bref). Other than sociodemographic factors, respondents were also evaluated for major depressive disorder, physical conditions as well as for social network, support and engagement. Using linear regression modeling, these factors were explored for their ability to predict the physical, psychological, social and environmental domains of QoL. Economic status was the most consistent predictor of the four domains of QoL, with the coefficients ranging between 1.0 and 1.68 (p < 0.001 in every instance). Among health variables, functional disability (range: 7.07-19.86) and self-rated overall health (range: 7.89-18. 42) were the most salient. Participation in community activities (range 7.74-17.48) was the most consistent social predictor. Even though health factors are important, social factors, in particular those relating to the quality of social support and participation, are the most important predictors of QoL.

Randomised controlled trial of site specific advice on school travel patterns

AIMS

To evaluate the effect of site specific advice from a school travel coordinator on school travel patterns.

METHODS

Cluster randomised controlled trial of children attending 21 primary schools in the London boroughs of Camden and Islington. A post-intervention survey measured the proportion of children walking, cycling, or using public transport for travel to school, and the proportion of parents/carers very or quite worried about traffic and abduction. The proportion of schools that developed and implemented travel plans was assessed.

RESULTS

One year post-intervention, nine of 11 intervention schools and none of 10 control schools had travel plans. Proportions of children walking, cycling, or using public transport on the school journey were similar in intervention and control schools. The proportion of parents who were very or quite worried about traffic danger was similar in the intervention (85%) and control groups (87%). However, after adjusting for baseline and other potential confounding factors we could not exclude the possibility of a modest reduction in parental concern about traffic danger as a result of the intervention.

CONCLUSIONS

Having a school travel coordinator increased the production of school travel plans but there was no evidence that this changed travel patterns or reduced parental fears. Given the uncertainty about effectiveness, the policy of providing school travel coordinators should only be implemented within the context of a randomised controlled trial.