Abstract: FR-PO864
The Positive Association of Black Race with Kidney Diseases Among a Cohort of Pregnant Women May Be Related to a Higher Rate of Prior Nonsteroidal Anti-Inflammatory (NSAID) Use
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
- Gupta, Sonali, Albert Einstein College of Medicine, Bronx, New York, United States
- Wilson, Clara, Albert Einstein College of Medicine, Bronx, New York, United States
- Mohottige, Dinushika, Mount Sinai Health System, New York, New York, United States
- Vasa, Aastha, Albert Einstein College of Medicine, Bronx, New York, United States
- Jim, Belinda, Albert Einstein College of Medicine, Bronx, New York, United States
- Golestaneh, Ladan, Albert Einstein College of Medicine, Bronx, New York, United States
Background
Chronic kidney disease (CKD) portends adverse outcomes for women of reproductive age. Black women have greater CKD prevalence and worse pregnancy outcomes compared to their counterparts. However, key contributors to these racial disparities in CKD and pregnancy outcomes are poorly described.
Methods
We conducted a retrospective cohort study of 21,603 pregnant women who were hospitalized in a large New York City health system in Bronx, NY, between January 1, 2016 and December 31, 2020 and identified 1,289 (5.9%) pregnant patients with preexisting CKD (as defined by eGFR<60 or proteinuria/albuminuria>200mg within 5 years prior to hospitalization). Data was extracted on socio-demographic variables, comorbidities, prior prescriptions for NSAIDS and smoking. We describe socio-demographic and behavioral characteristics (e.g., SES, marital status, smoking status), prior comorbid conditions (e.g. SLE, sickle cell, HTN), and prior NSAID prescription use among those with and without CKD. We quantified the association between preexisting CKD and race/ethnicity using logistic regression, adjusting for age, comorbidities, SES, prior NSAID use and smoking.
Results
Pregnant women with kidney disease (versus without) had higher prevalence of chronic HTN, prior preeclampsia, diabetes, antiphospholipid syndrome, sickle cell disease, systemic lupus and heart failure (p<0.001) and higher prior NSAIDs prescriptions (65.32% vs 41.74%, p<0.001). The majority of prescriptions were written for high dose ibuprofen (600-800mg), naproxen (500 mg) and indomethacin (500mg). After adjusting for age, BMI comorbidity, insurance type and SES, Black women had a 1.46 greater odds of CKD prevalence (p=0.03). After further adjustment for prior NSAID prescriptions, the association between Black race and CKD prevalence was no longer statistically significant (OR 1.37; p=0.08).
Conclusion
Black pregnant women have a higher rate of pre-existing CKD than their counterparts. Further investigation of racial disparities in NSAID use and their contribution to disparities in CKD prevalence among pregnant women is needed.