Infertility and Pregnancy Loss in Hispanic/Latino Women with Chronic Kidney Disease: Results from the Hispanic Community Health Study/ Study of Latinos (HCHS/SOL)

Abstract

Background: Hispanic/Latino individuals are less likely to receive optimal treatment for chronic kidney disease (CKD) than non-Hispanic whites. This may be particularly detrimental for women of reproductive age as CKD may increase risk for infertility, menstrual irregularities, and pregnancy loss. While these maternal outcomes have been associated with advanced CKD, their occurrence in mild to moderate CKD is unclear. Methods: Using baseline (2008-2011) and second study visit (2014-2017) data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), we assessed the association between CKD and self-reported infertility, cessation of menses, hysterectomy, and nonviable pregnancy loss (experienced at less than 24 weeks gestation) in women of reproductive age (18-45 years). Multivariable survey logistic regression analyses were used to compute prevalence odds ratios with 95% confidence intervals (OR, 95% CI). Results: Of the 2,589 women included (mean age 31.4 years), 4.6% were considered to have CKD. In adjusted analyses, women with CKD did not have a significantly increased odds of infertility (OR 1.02, 95% CI 0.42 - 2.49), cessation of menses (OR 1.25, 95% CI 0.52 - 3.04) or hysterectomy (OR 1.17, 95% CI 0.61 - 2.25) compared to those without CKD. In those with CKD, the adjusted odds of a nonviable pregnancy loss was increased when considering pregnancies occurring after baseline visit (OR 2.11, 95% CI 0.63 - 7.02) but not statistically significance. Conclusion: In our Hispanic/Latino cohort, the presence of mild to moderate CKD did not confer an additional risk of our outcomes of interest. Examining nonviable pregnancy loss after CKD diagnosis in a larger sample warrants further study.