Effect of HELLP syndrome on acute kidney injury in pregnancy and pregnancy outcomes: a systematic review and meta-analysis

BMC Pregnancy Childbirth. 2020 Oct 30;20(1):657. doi: 10.1186/s12884-020-03346-4.


Background: HELLP syndrome may increase adverse pregnancy outcomes, though the incidence of it is not high. At present, the impact of HELLP syndrome on P-AKI (acute kidney injury during pregnancy) and maternal and infant outcomes is controversial. Thus, we conducted a meta-analysis to find out more about the relationship between HELLP syndrome and P-AKI and pregnancy outcomes.

Methods: We systematically searched PubMed, Embassy and Cochrane Databases for cohort studies and RCT to assess the effect of HELLP syndrome on P-AKI and maternal and infant outcomes. Study-specific risk estimates were combined by using fixed-effect or random-effect models.

Results: This meta-analysis included 11 cohort studies with a total of 6333 Participants, including 355 cases of pregnant women with HELLP syndrome and 5979 cases that without. HELLP syndrome was associated with relatively higher risk of P-AKI (OR4.87 95% CI 3.31 ~ 7.17, P<0.001), fetal mortality (OR1.56 95% CI 1.45 ~ 2.11, P<0.001) and Maternal death (OR3.70 95% CI 1.72 ~ 7.99, P<0.001).

Conclusions: HELLP syndrome is associated with relatively higher risk of P-AKI, fetal mortality and maternal death.

Keywords: AKI; Acute kidney injury; HELLP syndrome; Pregnancy outcomes.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Acute Kidney Injury / epidemiology*
  • Acute Kidney Injury / etiology
  • Female
  • Fetal Mortality*
  • HELLP Syndrome / epidemiology*
  • Humans
  • Incidence
  • Maternal Death*
  • Pregnancy
  • Pregnancy Outcome
  • Risk Assessment
  • Risk Factors