biostudies-literatureUnknown7(12)Gupta S<h4>Rationale & objective</h4>Pregnant women with prepregnancy chronic kidney disease (CKD) are underdiagnosed and experience adverse outcomes. Limited research exists on peripregnancy health care utilization by women with evidence of CKD.<h4>Study design</h4>Retrospective cohort analysis.<h4>Setting & participants</h4>Women with laboratory signs of prepregnancy CKD who had a pregnancy event between January 1, 2016, and March 1, 2023, at Montefiore Health System in Bronx, NY, were included.<h4>Exposure & outcomes</h4>We investigated rates of CKD diagnosis, adverse maternal and fetal outcomes, and peripregnancy health care utilization among a sample of women with evidence of prepregnancy CKD.<h4>Analytical approach</h4>We tested the proportion of women with laboratory signs of CKD who had a diagnosis code for CKD entered on their problem list. We also examined the association of different eGFR/proteinuria cutoffs among the cohort with (1) adverse pregnancy outcomes, (2) postpregnancy CKD prevalence, and (3) peripregnancy health utilization.<h4>Results</h4>Of the 247 pregnant women who met criteria for prepregnancy CKD by estimated glomerular filtration rate (eGFR) or proteinuria, 8.1% had spontaneous abortion, 10.9% had missed abortion, 12.9% had CKD listed in problem list. Out of 80.9% of pregnancy that reached fetal viability, 12.5% had early preterm delivery, 22.6% developed gestational hypertension, and 20.0% of their infants required neonatal intensive care unit admission, with worse outcomes seen in those with severe CKD (defined as eGFR < 45 mL/min/1.73 m² or proteinuria > 1,000 mg/g). Among women with CKD, 27.6% were seen by primary care within 1 year before pregnancy while less than 0.1% were ever seen by a nephrologist. Among women with severe CKD, only 40% were seen by nephrology during pregnancy, and less than 50% had a nephrology appointment arranged at discharge.<h4>Limitations</h4>Retrospective analysis of a single-center data source.<h4>Conclusions</h4>Pregnant women with CKD were frequently underdiagnosed and not sufficiently integrated into care before, during, or after pregnancy.Kidney medicine101147https://www.ebi.ac.uk/biostudies/studies/S-EPMC12677166biostudies-literatureHealth Care Utilization Among Pregnant Women With Pre-existing Kidney Disease: A Retrospective Cohort Analysis.PMC12677166Gupta SJim BVasa ACervantes LReidy KGolestaneh LVani KRizzolo KIsaac JWolfe DfalseHealth Care Utilization Among Pregnant Women With Pre-existing Kidney Disease: A Retrospective Cohort Analysis.<h4>Rationale & objective</h4>Pregnant women with prepregnancy chronic kidney disease (CKD) are underdiagnosed and experience adverse outcomes. Limited research exists on peripregnancy health care utilization by women with evidence of CKD.<h4>Study design</h4>Retrospective cohort analysis.<h4>Setting & participants</h4>Women with laboratory signs of prepregnancy CKD who had a pregnancy event between January 1, 2016, and March 1, 2023, at Montefiore Health System in Bronx, NY, were included.<h4>Exposure & outcomes</h4>We investigated rates of CKD diagnosis, adverse maternal and fetal outcomes, and peripregnancy health care utilization among a sample of women with evidence of prepregnancy CKD.<h4>Analytical approach</h4>We tested the proportion of women with laboratory signs of CKD who had a diagnosis code for CKD entered on their problem list. We also examined the association of different eGFR/proteinuria cutoffs among the cohort with (1) adverse pregnancy outcomes, (2) postpregnancy CKD prevalence, and (3) peripregnancy health utilization.<h4>Results</h4>Of the 247 pregnant women who met criteria for prepregnancy CKD by estimated glomerular filtration rate (eGFR) or proteinuria, 8.1% had spontaneous abortion, 10.9% had missed abortion, 12.9% had CKD listed in problem list. Out of 80.9% of pregnancy that reached fetal viability, 12.5% had early preterm delivery, 22.6% developed gestational hypertension, and 20.0% of their infants required neonatal intensive care unit admission, with worse outcomes seen in those with severe CKD (defined as eGFR < 45 mL/min/1.73 m² or proteinuria > 1,000 mg/g). Among women with CKD, 27.6% were seen by primary care within 1 year before pregnancy while less than 0.1% were ever seen by a nephrologist. Among women with severe CKD, only 40% were seen by nephrology during pregnancy, and less than 50% had a nephrology appointment arranged at discharge.<h4>Limitations</h4>Retrospective analysis of a single-center data source.<h4>Conclusions</h4>Pregnant women with CKD were frequently underdiagnosed and not sufficiently integrated into care before, during, or after pregnancy.2025-01-01T00:00:00Z2025 Dec2026-06-05T23:33:00.103Z2026-05-23T03:13:42.639ZS-EPMC126771664135776310.1016/j.xkme.2025.101147