G AARTI1, S MCDONALD1,2, S JESUDASON2
1Australian and New Zealand Dialysis and Transplant Registry, Adelaide, Australia, 2Central and Northern Adelaide Renal and Transplantation Service (CNARTS), Royal Adelaide Hospital, Adelaide, Australia
Aim: To explore the birth rates of babies born to mothers requiring renal replacement therapy (RRT).
Background: Pregnancy in women receiving Renal Replacement Therapy (RRT) is uncommon but potentially high-risk. Accurate prevalence rates in the Australian population are unknown. ANZDATA collects parenthood data but we suspect it is potentially under-reported.
Methods: We linked SA mandatory perinatal data collection records for births > 20 weeks gestation or 400g birth weight occurring in 1991-2013, with ANZDATA (1978-2015) to identify babies born to mothers within the ANZDATA cohort. RRT modality at conception was calculated from gestational age.
Results: Of 440863 births in SA during the study period, 299 babies were born to 192 women who received RRT at any time in their life to 2015 at a rate of 0.68 births /1000 births. Of these, 162 women had a pregnancy only before starting RRT; 33 had a Pregnancy after starting RRT; and 3 had pregnancies both before and after. Overall there were 49 babies born,10 babies were born to women receiving chronic dialysis at conception (0.02 /1000 births); 2 women started dialysis during pregnancy and 39 were born to mothers who had functioning transplant at conception ( 0.09 /1000 births). During 1991-2013, Only 38 births in SA with gestational age > 20 weeks were reported to ANZDATA (3 to dialysed mothers, 33 to transplanted mothers; 2 women commenced chronic dialysis during pregnancy).
Conclusions: Linking ANZDATA with mandatory perinatal data records identifies more births than those reported to ANZDATA directly. Having identified these births, detailed perinatal data that is not captured by ANZDATA can be analysed to better understand the impact of RRT on pregnancy outcomes.
Dr Shilpa Jesudason, MBBS, PhD, FRACP, is a Staff Specialist Nephrologist and Chair of the Clinical Research Group at the Royal Adelaide Hospital’s Central Northern Adelaide Renal and Transplant Service (CNARTS). Her clinical and research interests include Parenthood in Patients with Kidney Disease. She runs a Renal Pregnancy Clinic for preconception counselling, antenatal and postnatal care, and her research program employs a broad array of methodologies (population data linkage, registry, cohort studies, qualitative, systematic reviews, basic science) to investigate parenthood outcomes for women and men with renal disease. She is also the Clinical Director of Kidney Health Australia