Abstract: FR-PO1021
Pregnancy Outcomes Among Women Receiving Dialysis: National Trends in Delivery Hospitalization, 2016-2022
Session Information
- Hemodialysis: Clinical Challenges, Patient-Centered Outcomes, and Quality of Life
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Dialysis
- 801 Dialysis: Hemodialysis and Frequent Dialysis
Author
- He, Mingyue, Baylor College of Medicine, Houston, Texas, United States
Background
Pregnancy among women with kidney failure (KF) receiving dialysis has historically been rare and associated with poor fetal outcomes. Although advances in dialysis care and multidisciplinary maternal-fetal management may have improved pregnancy outcomes, contemporary national trends remain incompletely characterized.
Methods
Using the National Inpatient Sample from 2016 to 2022, we identified adult delivery hospitalizations and categorized them as occurring among women with KF receiving dialysis or among controls without chronic kidney disease (NCKD). We compared maternal characteristics, obstetric complications, fetal outcomes recorded during the delivery hospitalization, length of stay, and resource utilization. Temporal trends in selected outcomes were assessed across study years.
Results
Among 25,016,672 delivery hospitalizations from 2016 to 2022, 1,625 occurred among women with KF on dialysis and 24,989,317 among NCKD controls. All women in the dialysis cohort received hemodialysis during the delivery hospitalization. Delivery hospitalizations among women receiving dialysis increased modestly from 6.7 to 7.8 per 100,000 deliveries during the study period. Among women receiving dialysis, rates of cesarean delivery, preeclampsia/eclampsia, preterm labor, live birth, fetal growth restriction, and fetal distress remained relatively stable over time.
Pregnancy complications among women with KF included gestational hypertension in 2.2%, preeclampsia/eclampsia in 20.0%, placental complications in 6.2%, premature rupture of membranes in 6.5%, venous thromboembolism in 2.2%, pulmonary edema in 6.5%, preterm labor in 17.2%, postpartum hemorrhage in 10.5%, postpartum infection/sepsis in 4.9%, blood transfusion in 16.0%, vasopressor use in 1.2%, and mechanical ventilation in 1.2%. Fetal outcomes included fetal growth restriction in 18.8%, congenital anomalies in 2.8%, fetal death/stillbirth in 9.9%, and fetal distress in 29.5%. Compared with NCKD controls, KF was associated with higher odds of adverse maternal, obstetric, fetal, and resource outcomes, including longer hospitalization and greater resource utilization.
Conclusion
Despite advances in dialysis and maternal-fetal care, pregnant women receiving dialysis continued to experience high rates of maternal, obstetric, fetal, and severe peripartum complications.