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Abstract: TH-PO731

Contraceptive Use and Elective Terminations in Women with Glomerular Disease

Session Information

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, Cary, North Carolina, United States
  • Poulton, Caroline J., UNC Kidney Center, Chapel Hill, North Carolina, United States
  • Blazek, Lauren N., UNC Kidney Center, Chapel Hill, North Carolina, United States
  • Nichols, Austin K., Univeristy of North Carolina, Carthage, North Carolina, United States
  • Hogan, Susan L., University of North Carolina, Chapel Hill, Chapel Hill, North Carolina, United States
  • Falk, Ronald J., UNC Kidney Center, Chapel Hill, North Carolina, United States
  • Derebail, Vimal K., University of North Carolina at Chapel Hill, Cary, North Carolina, United States
Background

As pregnancy with glomerular disease is considered high-risk, proactive planning is desired. Contraceptive preferences, including use of long-acting reversible contraception (LARC) that avoids estrogen associated hypertension (HTN) and venous thromboembolism (VTE), as well as elective termination rates in this population are largely unknown.

Methods

A women’s health survey was distributed by email, mail and in-person to women ages 18-65 in the Glomerular Disease Collaborative Network, a prospective registry in the southeastern United States (US). This analysis was restricted to reproductive age women (< 50 years). Fisher’s exact test assessed the association of elective terminations with race and disease type.

Results

Of 106 included (response rate 14.2%), the mean age was 36.7, BMI was 30.8 kg/m^2, and 17.9% were African-American (AA). The most common diseases were IgA nephropathy (27.4%), Lupus nephritis (22.6%), FSGS (17.0%) and ANCA vasculitis (13.2%). Half (54.7%) had HTN, 23.6% were past or current smokers and 12.3% reported prior VTE. Over one-third (38%) were either unsure or did not believe that kidney disease increases risk for pregnancy complications. A total of 72.6% utilized a birth control method in the past 12 months to prevent pregnancy; one-third of which endorsed ≥ 2 methods in that period. The most common methods included progesterone intrauterine device, condoms, pills, and withdrawal (see figure). At least one elective termination was reported by 16.0% and was higher in AA vs non-AA women (31.6% vs 12.6%, p= 0.08) though not statistically significant.

Conclusion

LARC use within the past 12 months was remarkably high, yet 61.1% endorsed methods associated with high failure rates. This data precludes distinguishing between concurrent use of multiple methods vs single successive methods. Elective termination rates were not significantly different among subgroups and overall rates appeared lower than the general US population (24% by age 45) but this may be due to underreporting.