Rate of Contraceptive Use Among Women with Kidney Failure is Low

There is a low rate of contraceptive use among women with kidney failure, according to a study published in Kidney Medicine.

Of women undergoing dialysis in the United States, the rate of contraceptive use is 5.3%. According to the study, this may account for a higher rate of unintentional pregnancies in this high-risk group.

Investigators examined the records of 35,732 women of childbearing age between January 1, 2005, and December 31, 2014. All of the participants were between 15 and 44 years of age and were on dialysis with Medicare as the primary payer. Data were collected using the United States Renal Data System, according to the study.

Contraceptive use was highest among women between 15 and 24 years of age, with 11.1% reporting birth control use. The rate of birth control use was lowest in women between 40 and 44 years of age, in which only 2.6% of patients reported using birth control. The results showed that being younger, of Native American and black race/ethnicity, having kidney failure due to glomerulonephritis, hemodialysis modality, and predialysis nephrology care were all associated with a higher likelihood of contraceptive use.

"Although end-stage kidney disease adversely impacts fertility, conception is common among women on dialysis. Kidney failure increases the risk of adverse pregnancy outcomes, including pre-eclampsia, fetal growth restriction and preterm babies," said lead study author Silvi Shah, MD, assistant professor in the Division of Nephrology, Kidney CARE Program at the University of Cincinnati, in a press release. "Unplanned pregnancies occur in women with kidney disease. It is of paramount importance that pregnancies in this high-risk population are planned and gives us the opportunity to counsel women about family planning and the impact of pregnancy on kidney disease, and the impact of kidney disease on maternal and fetal outcomes."

Limitations of the study do not account for natural methods of birth control or the use of condoms, according to the study authors. Investigators said that contraceptive counseling for women of childbearing years should be included in routine clinical care.

REFERENCE:

UC research finds low rates of contraceptive use in women with kidney failure [News Release] November 12, 2020; Cincinnati, OH. Accessed November 13, 2020. https://www.eurekalert.org/pub_releases/2020-11/uoc-urf111220.php.