Abstract: FR-PO869
Measurement of Kidney Function and Adverse Pregnancy Outcomes
Session Information
- Women's Health and Kidney Diseases
November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Women's Health and Kidney Diseases
- 2200 Women's Health and Kidney Diseases
Authors
- Lucas, Anika, Duke University School of Medicine, Durham, North Carolina, United States
- Feng, Yixuan, Duke University School of Medicine, Durham, North Carolina, United States
- Wyatt, Christina M., Duke University School of Medicine, Durham, North Carolina, United States
- Goldstein, Benjamin A., Duke University School of Medicine, Durham, North Carolina, United States
Background
Although it is estimated that 3% of women of childbearing age have kidney disease, there are no guidelines for routinely testing patients for kidney disease in the United States. Our objectives included identifying patients who received 1st and 2nd trimester serum creatinine measurements and evaluating rates of adverse pregnancy outcomes by level of kidney function.
Methods
Pregnant patients with serum creatinine measurements in the 1st and 2nd trimesters of pregnancy were identified in the electronic health record from 2014 to 2019. The 2021 Chronic Kidney Disease Epidemiology Collaboration Equation was used to calculate estimated glomerular filtration rate. Patients were divided into eGFR strata based on previously established eGFR cutoffs. Adverse pregnancy outcomes of interest included low birth weight, preterm birth, gestational hypertension, preeclampsia and a composite outcome.
Results
We identified 6460 patients who had creatinine measurements in the 1st trimester, representing 27% of patients receiving care during the 1st trimester. We further identified 5268 patients with a 2nd trimester creatinine, only 22% of patients receiving care in the 2nd trimester. Patients who received 1st trimester creatinine measurements were more likely to be <35 years old, Black and from disadvantaged areas. Patients with eGFR <90 ml/min/1.73 m2 in the 1st and 2nd trimesters of pregnancy had the highest rates of preterm birth. Patients with eGFR>150 ml/min/1.73 m2 had the highest rates of adverse outcomes, though a very small portion of the population.
Conclusion
Less than 1 in 3 patients had serum creatinine measurements available during the 1st and 2nd trimesters of pregnancy. More data is needed to evaluate the utility of creatinine measurements in pregnancy.
Funding
- Private Foundation Support