ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: TH-PO367

Pregnancy Delivery Rates Amongst Women of Child-Bearing Age with ESRD: 2002-2015

Session Information

Category: Dialysis

  • 701 Dialysis: Hemodialysis and Frequent Dialysis

Authors

  • Oliverio, Andrea L., University of Michigan, Ann Arbor, Michigan, United States
  • Bragg-Gresham, Jennifer L., University of Michigan, Ann Arbor, Michigan, United States
  • Saran, Rajiv, University of Michigan, Ann Arbor, Michigan, United States
  • Heung, Michael, University of Michigan, Ann Arbor, Michigan, United States
Background

Fertility is depressed in women with advanced CKD and ESRD and improves after transplant. Women with ESRD are at higher risk for pregnancy complications and loss. We sought to identify trends in delivery incidence amongst women with ESRD receiving renal replacement therapy (RRT) in the United States Renal Data System (USRDS).

Methods

We identified deliveries from inpatient claims of all prevalent female ESRD patients aged 18-44 yrs (n=650,282) between 2002-2015. Treatment modality at time of delivery was taken from treatment history files. Modality assignment for non-pregnant women was defined as last modality reported in each year. Rates were expressed as number of delivering women for every woman of child-bearing age receiving that RRT modality within each year. Logistic regression examined associations between patient characteristics and delivery.

Results

1833 deliveries were observed over the study period. Delivery rates increased overall from 0.23% to 0.34% from 2002-2015 (Figure). Rates were highest for transplant patients, while PD patients had significantly lower rates. Older age was associated with lower odds of delivery (OR=0.91 for each additional year, 95% CI: 0.91-0.92). Black and Hispanic women (compared to White) were more likely to deliver (OR=1.46, 95% CI: 1.29-1.65 and OR=1.44, 95% CI:1.26-1.65, respectively), as were women whose primary cause of ESRD (compared to diabetes) was glomerulonephritis (OR=1.78, 95% CI=1.49-2.13) and hypertension (OR=1.65, 95% CI: 1.35-2.02). For each additional year after ESRD diagnosis, the odds of delivery were lower by 3% (OR=0.98, 95% CI: 0.97-0.99).

Conclusion

The absolute number of deliveries for women of childbearing age with ESRD remains low, but is increasing. The rate of delivery in women receiving HD nearly doubled between 2002 and 2015. Further work is needed to identify factors contributing to this increase. Younger women with shorter ESRD vintage are more likely to deliver and it may be prudent to focus family planning counseling to this subset of patients.

Percentage of delivering women per year amongst prevalent female ESRD patients aged 18-44

Funding

  • NIDDK Support