Pregnancy and Breastfeeding for Women with CKD

​Women with chronic kidney disease (CKD), including those on dialysis or with kidney transplants, can become pregnant and breastfeed. However, pregnancy in these circumstances carries higher risks for both mother and baby compared to the general population. It's crucial to consult with your healthcare team if you're considering pregnancy.

Assessing Pregnancy Risks

The risk of pregnancy complications depends on various factors, including your age, medication history, and kidney function level. The type and activity of your kidney disease, blood pressure control, and proteinuria levels also play significant roles. Other health conditions such as obesity, diabetes, and hypertension, as well as any history of pre-eclampsia, are important considerations. Your healthcare team will assess these factors to provide personalised advice.

Women with CKD face an increased risk of worsening kidney function during pregnancy. There's also a higher likelihood of requiring a caesarean section, developing gestational diabetes, and experiencing pre-eclampsia. Pre-eclampsia is a particularly serious complication that typically occurs after 20 weeks of pregnancy, during labour, or shortly after delivery. It can lead to worsening kidney function, increased proteinuria, and maternal hypertension.

Pre-eclampsia may also result in poor foetal growth and premature delivery. In severe cases, it can cause organ damage and even seizures (eclampsia). To mitigate this risk, your doctor may prescribe low-dose acetylsalicylic acid (ASA).

Managing Your Pregnancy

Careful antenatal care is essential for women with CKD who become pregnant. Working with a specialised healthcare team, including your nephrologist and an obstetrician experienced in high-risk pregnancies, is crucial. They will monitor your pregnancy closely, watching for any early signs of complications and adjusting your care plan as needed.

Family Planning and Medication Safety

For women with CKD, family planning is of utmost importance. Discussing contraceptive options with your doctor can help you avoid unplanned pregnancies and allow you to work with your kidney specialist to identify the safest time for a planned pregnancy. Many medications used to treat CKD are unsafe during pregnancy and breastfeeding. However, safe alternatives are often available. It's vital to consult your nephrologist and pharmacist about your current medications and potential alternatives before conceiving and throughout your pregnancy and breastfeeding journey.

Key Considerations

While pregnancy is possible for women with CKD, it requires careful planning and management. Consulting your healthcare team before attempting to conceive is essential. Throughout your pregnancy, you'll need careful monitoring and specialised care. Be aware that many CKD medications may need to be adjusted or changed during pregnancy and breastfeeding. Remember, your healthcare team is your best resource for personalised advice and care throughout your CKD journey and potential pregnancy. They can provide the most up-to-date and relevant information for your specific situation, ensuring the best possible outcomes for both you and your baby.

Review our leaflet for more information:   Information for pregnant women with CKD.pdf