Effect of Chronic Kidney Disease Stage on Pregnancy Outcomes [10B

Abstract

INTRODUCTION: This study aims to estimate the risk of adverse pregnancy outcomes in women with stages 1-5 chronic kidney disease (CKD). METHODS: This is a retrospective cohort study of 2,039,870 singleton, non-anomalous pregnancies recorded in the California Birth Registry from 2006 to 2010, of which 93 were complicated by CKD. 27 women were classified as stage 1 or 2, 21 as stage 3, 10 as stage 4 and 35 as stage 5 CKD. Outcomes included: preeclampsia, preterm delivery, intrauterine fetal demise (IUFD), small for gestational age neonates (SGA), and mode of delivery. Results were stratified by parity and analyzed with Pearson Chi-squared Tests and multivariable logistic regression analyses. RESULTS: Compared to the general population, all stages of CKD resulted in higher rates of adverse pregnancy outcomes. Women with stage 4 CKD experienced the highest rates of preeclampsia, preterm delivery, and IUFD (60.0%, 100.0%, and 10.0% respectively, all P. CONCLUSION: Although all stages of CKD are associated with worse pregnancy outcomes compared with the general population, there was a non-linear relationship between the severity of pregnancy outcomes and degree of kidney dysfunction. Those with more progressed disease on renal replacement therapy may account for the improved outcomes. Further research with a larger cohort is needed to better understand the impact of this chronic disease on pregnancy.