Abstract: TH-PO738
Infertility and Pregnancy Loss in Hispanic/Latino Women with CKD: Results from the Hispanic Community Health Study/ Study of Latinos (HCHS/SOL)
Session Information
- Women's Health and Kidney Diseases
November 07, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Women’s Health and Kidney Diseases
- 2000 Women’s Health and Kidney Diseases
Authors
- Reynolds, Monica Lona, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
- Loehr, Laura R., University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
- Hogan, Susan L., University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
- Hu, Yichun, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
- Isasi, Carmen, Albert Einstein College of Medicine, Bronx, New York, United States
- Cordero, Christina, University of Miami, Miami, Florida, United States
- Ricardo, Ana C., University of Illinois at Chicago, Chicago, Illinois, United States
- Lash, James P., University of Illinois at Chicago, Chicago, Illinois, United States
- Derebail, Vimal K., University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
Background
Hispanic/Latino individuals are less likely to be screened or receive optimal CKD treatment. This may be particularly detrimental for reproductive age women as CKD has been associated with infertility, menstrual irregularities, and pregnancy loss.
Methods
Using data from the HCHS/SOL baseline (2008-2011) and second study visits (2014-2017), we assessed CKD and self-reported infertility, cessation of menses, and nonviable pregnancy loss (<24 weeks gestation) in women age 18-45 years old. CKD was defined as one of the following at both study visits: albuminuria (urine albumin:creatinine [UACR] >30 mg/g) or an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73m2. To capture mild CKD and variation in visit measurements, we also included those with UACR >300 mg/g at any visit, eGFR <60 mL/min/1.73m2at one visit and <70 mL/min/1.73m2 at the other, or if baseline UACR >30 mg/g while on RAAS-blockade. Survey-specific analyses were used to account for the two-stage probability sampling design. Multivariable survey logistic regression derived prevalence odds ratios (OR) with 95% confidence intervals for our outcomes of interest. Using a 10% change-in-estimate approach, covariates considered were age, body mass index (BMI), hypertension (HTN) and diabetes (DM).
Results
Of 2,589 included, 4.6% had CKD. Women with CKD were older (41 vs 38), had a higher BMI (34 kg/m2 vs 30 kg/m2), and more DM (32% vs 11%) and HTN (42% vs 12%). In adjusted analysis, those with CKD did not have a significantly increased odds of infertility, cessation of menses, or nonviable loss (see table). Among 635 women with pregnancies occurring specifically between baseline and second visit, the OR of nonviable loss with CKD was 1.7 (95% CI 0.5-5.8) but not statistically significant.
Conclusion
In this Hispanic/Latino cohort, CKD was uncommon and not associated with our outcomes of interest but our sample size limited statistical power. Considering the temporality of CKD diagnosis and pregnancy in a larger sample warrants further study.
| Infertility | Cessation of Menses | History of Nonviable Loss (total N= 2277, no CKD N= 2167, CKD N= 112) | |||||
| Characteristic | N | Unadjusted OR (95% CI) | Adjusted* OR (95% CI) | Unadjusted OR (95% CI) | Adjusted^ OR (95% CI) | Unadjusted OR (95% CI) | Adjusted^ OR (95% CI) |
| No CKD | 2469 | Reference | Reference | Reference | Reference | Reference | Reference |
| CKD | 120 | 1.20 (0.49-2.95) | 1.08 (0.42-2.75) | 2.15 (1.15-4.00) | 1.30 (0.52-3.27) | 0.82 (0.50-1.33) | 0.78 (0.47-1.29) |
*Adjusted for presence of DM ^Adjusted for age