Department of Women and Children's Health, School of Life Course Sciences, King's College London, 5th Floor Addison House, Guy's Campus, London, SE1 1UL, UK.
Department of Obstetric Medicine, Bart's and the London NHS Foundation Trust, London, UK.
J Nephrol. 2023 Jun;36(5):1361-1372. doi: 10.1007/s40620-023-01610-2. Epub 2023 Mar 27.
Women with Chronic Kidney Disease (CKD) are at increased risk of adverse pregnancy and renal outcomes. It is unknown how women with CKD understand their pregnancy risk. This nine-centre, cross-sectional study aimed to explore how women with CKD perceive their pregnancy risk and its impact on pregnancy intention, and identify associations between biopsychosocial factors and perception of pregnancy risk and intention.
Women with CKD in the UK completed an online survey measuring their pregnancy preferences; perceived CKD severity; perception of pregnancy risk; pregnancy intention; distress; social support; illness perceptions and quality of life. Clinical data were extracted from local databases. Multivariable regression analyses were performed. Trial registration: NCT04370769.
Three hundred fifteen women participated, with a median estimated glomerular filtration rate (eGFR) of 64 ml/min/1.73m(IQR 56). Pregnancy was important or very important in 234 (74%) women. Only 108 (34%) had attended pre-pregnancy counselling. After adjustment, there was no association between clinical characteristics and women's perceived pregnancy risk nor pregnancy intention. Women's perceived severity of their CKD and attending pre-pregnancy counselling were independent predictors of perceived pregnancy risk. Importance of pregnancy was an independent predictor of pregnancy intention but there was no correlation between perceived pregnancy risk and pregnancy intention (r = - 0.002, 95% CI - 0.12 to 0.11).
Known clinical predictors of pregnancy risk for women with CKD were not associated with women's perceived pregnancy risk nor pregnancy intention. Importance of pregnancy in women with CKD is high, and influences pregnancy intention, whereas perception of pregnancy risk does not.
患有慢性肾脏病（CKD）的女性发生不良妊娠和肾脏结局的风险增加。目前尚不清楚患有 CKD 的女性如何看待自己的妊娠风险。这项由九个中心参与的横断面研究旨在探讨患有 CKD 的女性如何感知自己的妊娠风险及其对妊娠意愿的影响，并确定生物心理社会因素与感知妊娠风险和意愿之间的关系。
英国患有 CKD 的女性完成了一项在线调查，该调查测量了她们的妊娠偏好；感知 CKD 严重程度；感知妊娠风险；妊娠意愿；痛苦；社会支持；疾病认知和生活质量。从当地数据库中提取临床数据。进行多变量回归分析。试验注册：NCT04370769。
315 名女性参与了研究，中位估计肾小球滤过率（eGFR）为 64ml/min/1.73m（IQR 56）。234 名（74%）女性认为妊娠很重要或非常重要。只有 108 名（34%）接受过孕前咨询。调整后，临床特征与女性感知的妊娠风险和妊娠意愿之间没有关联。女性对 CKD 严重程度的感知和接受孕前咨询是感知妊娠风险的独立预测因素。妊娠的重要性是妊娠意愿的独立预测因素，但感知妊娠风险与妊娠意愿之间没有相关性（r=−0.002，95%CI−0.12 至 0.11）。
已知影响 CKD 女性妊娠风险的临床预测因素与女性感知的妊娠风险和妊娠意愿无关。患有 CKD 的女性对妊娠的重视程度很高，会影响其妊娠意愿，而感知妊娠风险则不会。
