Introduction:
Pregnancy is uncommon in women with end-stage kidney disease (ESKD) treated with dialysis. The main objectives of this study were to estimate the incidence rate of pregnancies among women receiving chronic dialysis from outsourcing dialysis program in Saudi Arabia, to describe the pregnancy outcomes and analysis the predictive factors.
Methods:
Study was based on data from the Diaverum registry of pregnancy in dialysis. There were a total of 9427 patients dialyzed in 40 centers during the study period (June 2013 to June 2024). 5468 males and 3959 females. 825 (2.2%) of whom were females of child bearing age (18 to 44 years). Out of the 825 females of the childbearing age, only 270 were married.
Results:
Over the 10 years study period, 26 pregnancies were identified in 25 women receiving chronic dialysis. The overall incidence was 6.91 per thousand patient years (PTPY) among female patients of childbearing age and was 24.76 among female of childbearing and married.
The average age of patients was 33.73 ± 4.55 years. 22 women were undergoing hemodialysis and 4 were undergoing hemodiafiltration. We modified the prescription of dialysis in 14 patients by increasing the frequency of the dialysis sessions to 6 per week and in 12 to 5 per week. The average number of pre-dialysis pregnancies was 3.5 ± 2.47. The average gestational age at diagnosis was 10.6 ± 4.2 weeks and the average gestational age at delivery was 29 ± 9.16 weeks. 19 delivered live births. There was 1 intrauterine fetal death, 1 neonatal death, and 5 spontaneous abortion. The overall rate of successful pregnancy was 73%. Low birth weight was observed in 15 cases, and cesarean section was performed in 9 women and spontaneous vaginal delivery in 17 women. The mean pre dialysis of urea, serum creatinine and hemoglobin were respectively 12.76 ± 6.61 mmol/l, 6.49 ± 2.05 mg/dl and 10.4 ± 1.27 g/l at delivery. higher weekly dose delivered associate with higher rate of successful pregnancy (R: 0.461, P : 0.018). No correlation with age, primary kidney disease, vascular access and dialysis duration before Diaverum.
Conclusions:
The pregnancy rate is higher in women on dialysis than previous reports. The likelihood of a surviving infant resulting from pregnancy in dialysis patients is higher than previously observed. There is a suggestion that increased dialysis dose may improve outcome.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.