Pregnancies in Women with Kidney Failure on Home Dialysis
Bibliographic record
Abstract
Background: Women with kidney failure have impaired fertility and are at a higher risk of maternal and fetal morbidity and mortality. Little is known about pregnancies in women receiving maintenance home dialysis in the United States. Methods: Using data from the United States Renal Data System, a cohort of 26,387 women aged 15-49 years with kidney failure receiving maintenance home dialysis in 2005-2018 was examined. We calculated pregnancy rates and identified factors including the modality associated with pregnancy on home dialysis. Results: Overall, 437 pregnancies were identified in 26,837 women on home dialysis. Unadjusted pregnancy rate was 8.6 per 1000 person-years (PTPY). The unadjusted pregnancy rate was higher on home hemodialysis (16.0 vs. 7.5 PTPY) than on peritoneal dialysis. Women on home hemodialysis had a higher adjusted likelihood of pregnancy than women on peritoneal dialysis (HR, 2.34; 95% CI, 1.79-3.05). Compared with women aged 20-24 years, the likelihood of pregnancy was lower in women 30-34 years (HR, 0.64; 95% CI, 0.43-0.96), 35-39 years (HR, 0.53; 95% CI, 0.35-0.79), 40-44 years (HR, 0.32; 95% CI, 0.21-0.49), and 45-49 years (HR, 0.21; 95% CI, 0.13-0.33). While Black women had a higher likelihood of pregnancy (HR, 1.40; 95% CI, 1.07-1.83), there was no difference in likelihood of pregnancy in Asian, Hispanic, and Native Americans as compared to Whites. Body mass index, cause of kidney failure, socioeconomic status, rurality, pre-dialysis nephrology care, or dialysis vintage were not significantly associated with pregnancy on home dialysis. Conclusions: The pregnancy rate in women with kidney failure undergoing home dialysis is higher with home hemodialysis than with peritoneal dialysis. Younger age and Black race/ethnicity are associated with a higher likelihood of pregnancy among women on home dialysis. This information can guide clinicians in preconception counseling and making informed treatment decisions for pregnant women on home dialysis. Funding: Other NIH Support - NHLBI K23 career development award, under Award Number 1K23HL151816-01A1
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".