02 Oct Racial & Ethnic Differences in Pregnancy Rates Among Women on Dialysis
MedicalResearch.com Interview with:
Silvi Shah, MD, MS, FACP, FASN| Assistant Professor
Division of Nephrology, University of Cincinnati
MedicalResearch.com: What is the background for this study?
Response: Our study uses data from the largest retrospective cohort of dialysis patients in the United States from the United States Renal Data System to determine pregnancy rates and factors associated with pregnancy in 47,555 women aged 15-44 years on dialysis. We identified 2,352 pregnancies with a rate of 17.8 pregnancies per 1000 person-years (PTPY) with the highest rate in women aged 20-24 years (40.9 PTPY).
MedicalResearch.com: What are the main findings?
Response: The present study shows racial/ethnic differences in the occurrence of pregnancy among women on dialysis. Native American, black and Hispanic women had a higher likelihood of pregnancy as compared to white women. Women with end-stage kidney disease (ESKD) due to glomerulonephritis, malignancy and hypertension had a higher likelihood of pregnancy than women with end-stage kidney disease due to diabetes, while women on peritoneal dialysis had a lower likelihood of pregnancy than women on hemodialysis.
MedicalResearch.com: What should readers take away from your report?
Response: Our study highlights higher pregnancy rates in women with end-stage kidney disease in the United States than the prior reports. Pregnancy therefore is not uncommon among women undergoing dialysis. Our report uses data from a national registry and did not have the limitation of the reporting bias from the surveys or voluntary registries. The study improves our understanding of various factors associated with pregnancy like race/ethnicity, ESKD cause and type of dialysis modality. This information is particularly important during pre-pregnancy counseling and shared decision making.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: The real reasons for racial and ethnic differences in pregnancy rates among women on dialysis remain unknown and further study future research is therefore needed to better understand and reduce these differences. We were also not able to determine the differences in unintentional and intentional pregnancies and whether level of education was associated with the likelihood of pregnancy.
MedicalResearch.com: Is there anything else you would like to add?
Response: I would like to thank my entire team at the University of Cincinnati who participated in the project. The research was supported by intramural funds of Division of Nephrology, Kidney C.A.R.E (Clinical Advancement, Research and Education) Program, University of Cincinnati. The authors have no disclosures.
Citation: Racial Differences and Factors Associated with Pregnancy in End Stage Kidney Disease Patients on Dialysis in the United States
Silvi Shah, Annette L. Christianson, Karthikeyan Meganathan, Anthony C. Leonard, Daniel P. Schauer and Charuhas V. Thakar
JASN September 2019, ASN.2019030234; DOI: https://doi.org/10.1681/ASN.2019030234
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