From improbable to possible: pregnancy with advanced chronic kidney disease

Abstract

Reproductive health is an acknowledged right, yet women with chronic kidney disease (CKD) not only face reduced fertility but also higher risks of adverse pregnancy outcomes for mother and baby. These risks are higher in underserved populations, but they can be minimized through empowerment, education and adequate health-care support.

In Mexico, nearly 37% of the population lives in poverty, with ~8% living in extreme poverty, and this social context affects access to health care. Consequently, after a first encounter at birth, often the second time a woman sees a doctor is when she gets pregnant. Kidney disease is therefore often undiagnosed and might only be detected during pregnancy. Poverty, low availability and limited quality of medical services, lack of family planning programmes, and a high frequency of adolescent pregnancy translate into high morbidity and mortality in high-risk pregnancies.