719 - Neonatal Outcomes of Delivery Hospitalizations among Pregnant Women with Kidney Disease in the United States

Publication Number: 719.6029

Silvi Shah, Silvi Shah, Montgomery, OH, United States; Prasoon Verma, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States

Background: Pregnancy with kidney disease is not uncommon. Little is known about neonatal outcomes of delivery hospitalizations among pregnant women with chronic kidney disease.

Objective: The objective of the study was to determine rates of neonatal complications and the risk of preterm births, live births, stillbirths, and cesarean sections in women with chronic kidney disease, as compared to those without kidney disease.

Design/Methods: Using data from the 2006 to 2015 Nationwide Inpatient Sample, we identified pregnancy-related delivery hospitalizations in women aged 15-49 years. Neonatal events, delivery methods, and chronic kidney disease were diagnosed using ICD-9-CM diagnosis and procedure codes. Adjusted logistic regression accounting for the survey weights was conducted to investigate the risk of neonatal complications in delivery hospitalizations among women with chronic kidney disease.

Results: A total of 7,886,836 hospitalizations resulting in delivery were identified, including 2763 among women with chronic kidney disease and 7,883,296 among women with no kidney diagnosis. Women with chronic kidney disease, as compared to those without kidney disease, had lower rates of live births (89.8% vs. 98.6%) and higher rates of preterm delivery (26.5% vs. 7.0%), higher rates of stillbirths (2.9% vs. 0.6%), and higher rates of cesarean section. (55.1% vs. 32.9%). Pregnant women with chronic kidney disease were at higher adjusted odds of preterm delivery (OR = 2.78, 95% CI [2.55, 3.04]), higher adjusted odds of stillbirths (OR = 5.26, 95% CI [4.72, 5.86]), higher adjusted odds of cesarean section (OR = 1.49, 95% CI [1.37, 1.63]), and were at lower adjusted odds of live births (OR = 0.37, 95%CI [0.32, 0.42]), as compared to women without kidney disease.

Conclusion(s): Pregnant women with chronic kidney disease are at higher risk of adverse neonatal complications during delivery when compared to women with no known kidney disease.