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Abstract: TH-PO759

Investigating the Psychological and Clinical Correlates of Pregnancy Risk and Pregnancy Intention in Women With CKD

Session Information

Category: Women's Health and Kidney Diseases

  • 2100 Women's Health and Kidney Diseases

Authors

  • Ralston, Elizabeth R., King's College London Faculty of Life Sciences and Medicine, London, London, United Kingdom
  • Chilcot, Joseph, King's College London Institute of Psychiatry Psychology and Neuroscience, London, London, United Kingdom
  • Clark, Katherine Rose, King's College London Faculty of Life Sciences and Medicine, London, London, United Kingdom
  • Smith, Priscilla, King's College London Faculty of Life Sciences and Medicine, London, London, United Kingdom
  • Bramham, Kate, King's College London Faculty of Life Sciences and Medicine, London, London, United Kingdom
Background

Women with Chronic Kidney Disease (CKD) are at increased risk of adverse pregnancy and renal outcomes. Risk perception is recognised to impact behaviour. This study aimed to understand how women with CKD perceive their pregnancy risk and understand what clinical and psychological factors are associated with perceived pregnancy risk and pregnancy intention.

Methods

Women aged between 18 and 50 years with CKD Stages 1-5 were recruited from nine renal units in the United Kingdom and asked to complete an online survey (October 2020 to December 2021). Demographic, pregnancy preference information, and psychological attributes (with validated tools) were measured. Clinical data were extracted from local databases. Multivariable linear regressions were performed.

Results

315 women participated, mean age 35 (7.1) with mean estimated glomerular filtration rate (eGFR) 62.2 ml/min/1.73m2 (SD 34.7).108 (34.4%) women had previously attended pre-pregnancy counselling and 234 (74%) reported pregnancy being important to very important. Women with CKD appear to have greater perceived pregnancy risk (46.0, SD 23) than previously reported in lower risk groups (24.0, SD 14.5). After adjustment no associations were reported between clinical characteristics including eGFR and women’s perceived pregnancy risk, but attendance to pre-pregnancy counselling (b = 6.5, 95% CI 1.5 to 11.4, p = 0.011) and women’s perceived kidney disease severity (b = 0.15, 95% CI 0.04 to 0.26, p = 0.010) were associated with perceived pregnancy risk. No correlation was reported between perceived pregnancy risk and pregnancy intention (r = -0.002, 95% CI -0.12 to 0.11, p = 0.97), there was also no association with clinical risk factors and pregnancy intention. Importance of pregnancy was the strongest associated factor with pregnancy intention (b = 0.4, 95% CI 0.2 to 0.5, p <0.001).

Conclusion

Women with CKD appear to perceive their pregnancy risk to be greater compared to pregnancies uncomplicated by CKD. The importance of pregnancy for women with CKD is high, but clinical status is not associated with their future pregnancy intention or perceived pregnancy risk.