Abstract: TH-PO744
Contraception Use Among a Cohort of Reproductive Aged Women With CKD
Session Information
- Sex and Reproductive Factors in Kidney Health
November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Women's Health and Kidney Diseases
- 2100 Women's Health and Kidney Diseases
Authors
- Carr, Audrey V., Massachusetts General Hospital Department of Medicine, Boston, Massachusetts, United States
- Strohbehn, Ian Austin, Massachusetts General Hospital Division of Nephrology, Boston, Massachusetts, United States
- Saly, Danielle L., Massachusetts General Hospital Division of Nephrology, Boston, Massachusetts, United States
- Tangren, Jessica Sheehan, Massachusetts General Hospital Division of Nephrology, Boston, Massachusetts, United States
Background
Pregnancy in women with chronic kidney disease (CKD) carries an elevated risk of preeclampsia, premature birth, low birth weight, and cesarean section. However, studies also suggest that family planning occurs infrequently in nephrology practices. Little is known about contraception practices in patients with CKD. Here we present data on contraception use in a cohort of reproductive-aged women receiving nephrology care in an academic medical network.
Methods
We conducted a retrospective analysis of women ages 18-40 years receiving ambulatory nephrology care in an academic hospital network between 2016-2020. Patients with documented tubal ligation, hysterectomy, or without two eGFR measurements >3 months apart were excluded. We analyzed contraception use patterns by age, CKD stage and teratogenic medication usage.
Results
593 patients met the inclusion criteria. Mean age in the cohort was 29 years. 77% (n=459) of patients had stage 1 or 2 CKD, 12% (n=70) had stage 3 CKD, 4% (n=24) had stage 4 CKD, and 7% (n=40) had stage 5 CKD. 54% of all patients had no documented method of contraception. Contraception use decreased with increasing CKD stage (p for trend <0.01, Figure 1). 52% patients treated with an ACEi or ARB had no documented form of contraception. Of those with a documented method of contraception, 22% used long-active reversible contraception (intrauterine device or implant), 22% used combined oral contraceptives or other estrogen containing method, and 18% used progesterone-only methods.
Conclusion
In this analysis of reproductive aged women with kidney disease, more than half had no documented method of contraception despite high rates of teratogenic medication use. Rates of contraceptive use were lowest in women with advanced CKD. More efforts are needed to increase use of contraception in women with kidney disease, especially in groups at high risk for adverse outcomes with unplanned pregnancies.
Use of contraception method by CKD stage. Contraception use decreased with increasing CKD stage (p for trend <0.01).
Funding
- NIDDK Support