SOMANZ Poster Presentation Australasian Diabetes in Pregnancy Society and Society of Obstetric Medicine Australia and New Zealand Joint Scientific Meeting 2025

PREGNANCY AND NEONATAL OUTCOMES IN WOMEN RECEIVING HOME-BASED DIALYSIS: AN ANALYSIS OF THE ANZDATA REGISTRY (#148)

Sagun Banjade 1 , Su Jen Chua 2 3 , Erin Vaughan 4 , Melanie Wyld 5 6 , Chris Davies 7 , Erandi Hewasasam 7 8 , Shilpa Jesudason 8 9
  1. Flinders Medical Centre, Adelaide, South Australia, Australia
  2. Department of Obstetric Medicine , Mercy Hospital for Women, Melbourne, Victoria, Australia
  3. Department of Obstetrics and Gynaecology , Evidence Based Women's Health Care Research Group, Melbourne, Victoria, Australia
  4. Department of Renal Medicine , Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
  5. Department of Renal Medicine, Westmead Hospital, Sydney, New South Wales, Australia
  6. University of Sydney, Faculty of Medicine and Health, Sydney, New South Wales, Australia
  7. Australia and New Zealand Dialysis and Transplant Registry (ANZDATA), South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia
  8. Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia
  9. Central Northern Adelaide Renal and Transplantation Service (CNARTS), Royal Adelaide Hospital, Adelaide, South Australia, Australia

BACKGROUND:
Pregnancy in women receiving home dialysis is uncommon, despite potential benefits such as prolonged dialysis hours, enhanced family support, and reduced hospital resource utilisation. Limited data may contribute to hesitancy in considering home dialysis during pregnancy.

AIM:
To examine fertility rates, pregnancy outcomes, and dialysis modality transitions in women receiving home dialysis.

METHODS:
A retrospective analysis of pregnancies reported to the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry from 2001–2023 was conducted.

RESULTS:
Among 149 pregnancies, fertility rates per 1000 women/year were 3.3 for home haemodialysis (HHD), 1.1 for peritoneal dialysis (PD), and 2.2 for in-centre dialysis (ICD). Dialysis modality at conception included HHD (13.4%), PD (8.7%), and ICD (35.6%); 57% were conceived before dialysis (CBD). Median dialysis duration at conception was shortest for PD (0.6 years, Interquartile Range,IQR 0.6-2.9), followed by ICD (1.3 years,IQR 0.6-2.9) and HHD (3.6 years,IQR 2.2-6.0) (p=0.017). About 85% continued their initial modality throughout pregnancy. Among CBD patients, 4.8% initiated home dialysis during pregnancy.

Preeclampsia occurred most frequently in PD (38.5%) and CBD (33.3%), compared to HHD (14.3%) and ICD (10%) (p=0.007). Live birth rates were similar across modalities (HHD:47.8%, PD:50%, ICD:47.2%). Median gestational age and birthweight did not significantly differ. Among women with dialysis vintage >3 years, PD was associated with the lowest median birthweight (959g), compared to HHD (1885g) and ICD (1584g) (p=0.07).

CONCLUSION:
Successful pregnancy outcomes are achievable with home dialysis, including initiation during pregnancy. These findings support broader consideration of home dialysis as a viable option.