Abstract: TH-PO732
Contraceptive Use Among Women with ESKD on Dialysis in the United States
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
- Shah, Silvi, University of Cincinnati, Cincinnati, Ohio, United States
- Christianson, Annette, Cincinnati VA, Cincinnati, Ohio, United States
- Meganathan, Karthikeyan, University of Cincinnati, Cincinnati, Ohio, United States
- Leonard, Anthony C., University of Cincinnati, Cincinnati, Ohio, United States
- Thakar, Charuhas V., University of Cincinnati, Cincinnati, Ohio, United States
Background
Pregnancy in women with end-stage kidney disease (ESKD) is challenging. Nephrologists do not routinely counsel dialysis patients about contraception and little is known about contraceptive use in women with ESKD.
Methods
Using the United States Renal Data System from 1/1/2005 to 12/31/2014, we evaluated for each calendar year women aged 15-44 years who were on dialysis and had Medicare as the primary payer for the entire year. We studied trends in the use of contraceptive methods and used multivariable logistic regression with covariates and year, with subject as a repeated effect, to determine factors associated with contraceptive use.
Results
The study cohort included 36,450 women with 122,982 person-years. Mean maternal age was 34±6 year. Rate of any form of contraceptive use during the study period was 7.3 per 100 person-years (PHPY). Contraceptive use increased significantly from 2005 to 2014 (9.2 PHPY vs. 5.4 PHPY). From 2005 to 2014, the rate of intrauterine device insertions increased from 0.8 PHPY to 2.6 PHPY, tubal ligation rate increased from 0.4 PHPY to 0.2 PHPY, implant insertion rate increased from 0.1 to 0.4 PHPY, and hysterectomy rate increased from 1.6 PHPY to 3.7 PHPY. All races except Asians had a consistent increase in contraceptive use from 2005-2014. Compared to women aged 20–24 years, the contraception use was lower in women aged 25-29 years (OR, 0.81; CI, 0.74-0.89) and 30–34 years (OR, 0.65; CI, 0.41-0.77). As compared to white women, Asian women had lower contraceptive use (OR, 0.81; CI, 0.69-0.96) and Native American women had higher contraceptive use (OR, 1.34; CI, 1.09-1.64). As compared to women residing in southern areas, contraceptive use was lower in women residing in northeastern areas (OR, 0.85; CI, 0.77-0.93). Women with ESKD due to glomerulonephritis had higher contraceptive use than women with ESKD due to diabetes (OR, 1.20; CI, 1.10-1.31).
Conclusion
There has been a statistically significant increase in contraceptive use in women with ESKD on dialysis in the last decade. Younger age, Native American race, and ESKD due to glomerulonephritis were associated with higher likelihood of contraceptive use in ESKD patients.