Poster Presentation Society of Obstetric Medicine of Australia and New Zealand ASM 2026

MATERNAL AND NEONATAL OUTCOMES IN PREGNANT WOMEN RECEIVING DIALYSIS: INDIVIDUAL PATIENT DATA ANALYSIS FROM A SYSTEMATIC REVIEW (#141)

Jolene Ng 1 2 , Meena Khandelwal 3 , Mary Bridgeman 4 , Merlijn Wind 5 , Lauren Walheim 6 , Theepika Rajkumar 1 , Angela Makris 1 2
  1. Department of Renal Medicine, Department of Obstetric Medicine, South West Sydney LHD, Sydney, NSW, Australia
  2. The University of New South Wales, Sydney, NSW, Australia
  3. Department of Obstetrics and Gynecology, Jefferson Maternal Fetal Medicine, Jefferson Health, Abington, Pennsylvania, USA
  4. Ernest Mario School of Pharmacy, Rutgers University, Piscataway, NJ, USA
  5. Department of Obstetrics, Leiden University Medical Center, Leiden, The Netherlands
  6. Department of Obstetrics & Gynecology, Pennsylvania Hospital, Philadelphia, PA, USA

AIM
To describe maternal and neonatal outcomes among women with kidney failure receiving dialysis during pregnancy using pooled individual patient data.

BACKGROUND
Pregnancy in women receiving dialysis is uncommon and remains associated with substantial maternal and neonatal morbidity. As part of a systematic review and meta-analysis informing clinical guidelines on dialysis in pregnancy, we analysed pooled individual patient data to characterise outcomes.

METHODS
Individual patient data from 29 published cohorts (1988-2025) were pooled. Maternal characteristics, dialysis parameters, obstetric and neonatal outcomes were extracted. Continuous variables are presented as median (IQR) and categorical variables as proportions.

RESULTS
A total of 213 viable pregnancies were included. Median maternal age was 31 years (IQR 27–35). Among women established on dialysis at conception, median dialysis vintage was 40 months (IQR 19.8–84) and median haemodialysis intensity was 23 hours/week (IQR 20–24). Overall, median gestational age at delivery was 33 weeks (IQR 30–35) and median birth weight was 1690 g (IQR 1115–2190). Preterm birth (<37 weeks) occurred in 87.4%, very preterm birth (<34 weeks) in 58.6%, low birth weight (<2500 g) in 88.9%, and very low birth weight (<1500 g) in 44.2%. Caesarean delivery occurred in 68.5% of pregnancies. NICU admission occurred in 76.1% of neonates, of whom 86.8% required respiratory support.

CONCLUSIONS
Pregnancy in women receiving dialysis remains associated with persistent risks of extreme prematurity, low birth weight and neonatal morbidity. Maternal outcomes were inconsistently reported, limiting estimation of risk and highlighting the need for standardised outcome reporting. These contemporary data support preconception counselling, prognostication and multidisciplinary pregnancy care.