PREGNANCY AMONG WOMEN ON CHRONIC DIALYSIS : THE FRENCH COHORT

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https://storage.unitedwebnetwork.com/files/1099/6ac3afb74519a3e90360a01f4e973ff2.pdf

Abstract Title

First Name *

Cécile

Last Name *

Couchoud

Co-author 1

Hayet Baouche hayet.baouche@aphp.fr Hôpital. Necker-Enfants Malades, APHP Laboratoire de Biostatistique et d'Informatique Médicale Pairs

Co-author 2

Jean Philippe Jais jean-philippe.jais@aphp.fr Hôpital. Necker-Enfants Malades, APHP Laboratoire de Biostatistique et d'Informatique Médicale Paris

Co-author 3

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Introduction

Methods

This national observational, retrospective study was based on data from the French REIN registry matched with data from the National Health Data System.

Results

Over the period 2006–2020 in France, 348 pregnancies were identified in 240 women on chronic dialysis. The overall incidence of pregnancy was 11.1, 95% CI (10.0–12.4) cases per 1000 Woman-Years. Hemodialysis was the predominant modality during pregnancy. Main maternal complications were preeclampsia 19 (5.4%) and gestational diabetes 11 (3.1%).

These pregnancies resulted in 174 (50%) abortions (<22 weeks), including 104 elective abortions (29.9%), 44 miscarriages (12.6%), 17 therapeutic abortions (4.9%), 5 ectopic pregnancies (1.4%) and 4 hydatidiform moles (1.2%).

The remaining 174 (50%) pregnancies with deliveries (≥22 weeks) resulted in 166 (47.7%) live births - 70 (42.2%) full-term, 96 (57.8%) preterm births- , and 8 (2.3%) stillbirths. Median gestational age was 36 (32–38) weeks for 174 deliveries.

Daily dialysis was highly associated with delivery probability (P <0.0001) versus conventional dialysis.

Conclusions

There have been improvements in maternal and fetal outcomes regarding pregnancy on chronic dialysis.

However, our study shows a significant proportion of elective abortions. Contraception or pregnancy planning and early multidisciplinary follow-up could advice better fertility management of women on chronic dialysis.

(1) Pregnancy in women on chronic dialysis in the last decade (2010-2020): a systematic review. Clin Kidney J. 2022 Sep 12;16(1):138-150

Partial results were presented at the congress of the SFNDT 2023 in Liège, Belgium.

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