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Abstract: PO2605

Outcomes of Delivery Hospitalizations Among Pregnant Women with Kidney Transplant in the United States

Session Information

Category: Women’s Health and Kidney Diseases

  • 2000 Women’s Health and Kidney Diseases

Authors

  • Chewcharat, Api, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Kattah, Andrea G., Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Thongprayoon, Charat, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Cheungpasitporn, Wisit, University of Mississippi Medical Center, Jackson, Mississippi, United States
  • Boonpheng, Boonphiphop, University of California Los Angeles, Los Angeles, California, United States
  • Gonzalez Suarez, Maria Lourdes, University of Mississippi Medical Center, Jackson, Mississippi, United States
  • Craici, Iasmina, Mayo Clinic Minnesota, Rochester, Minnesota, United States
  • Garovic, Vesna D., Mayo Clinic Minnesota, Rochester, Minnesota, United States
Background

Outcomes of delivery hospitalizations, including acute kidney injury, obstetric and fetal events among pregnant women with kidney transplants (KT) compared to those with no known kidney disease and chronic kidney disease (CKD) stage 3-5 are unclear.

Methods

Hospitalizations for delivery were identified using the enhanced delivery identification method in the National Inpatient Sample dataset from the years 2009 to 2014. Diagnoses of CKD stage 3-5, KT along with obstetric events, delivery methods, and fetal events were identified using ICD-9-CM diagnosis and procedure codes. Logistic regression accounting for the survey weights and matched regression were conducted to investigate the risk of maternal and fetal complications in women with KT as compared to women with no kidney-related diagnosis and compared to women with CKD stage 3-5.

Results

A total of 5,408,215 hospitalizations resulting in delivery were identified, including 405 women with CKD stage 3-5, 295 women with functioning KT, and 5,405,499 women with no kidney diagnosis. , Pregnant KT recipients were at higher odds of pregnancy-induced hypertension (OR = 3.11, 95%CI [2.26, 4.28]), preeclampsia/eclampsia/HELLP syndrome (OR = 3.42, 95%CI [2.54, 4.60]), preterm delivery (OR = 2.46, 95%CI [1.75, 3.45]),fetal growth restriction (OR = 1.74, 95%CI [1.01, 3.00]), and acute kidney injury (OR = 10.46, 95%CI [5.33, 20.56]) as compared to women with no kidney-related diagnosis. There were no significant differences in rates of gestational diabetes and cesarean section. Pregnant women with KT had 1.30-time longer length of stay and 1.28-time higher cost of hospitalization. However, pregnant women with CKD stage 3-5 were at higher odds of AKI, preeclampsia/eclampsia/HELLP syndrome and fetal death, and had longer hospital stay and cost of hospitalization compared to pregnant women with KT.

Conclusion

Pregnant women with KT were more likely to experience adverse events during delivery when compared to women with no known kidney disease. However, pregnant women with advanced CKD were more likely to experience serious complications than KT recipients. Women with advanced CKD who wish to conceive might consider conception after transplantation for better pregnancy-related outcomes.