TOPLINE:

Children born to mothers receiving chronic dialysis had significantly higher rates of prematurity, low birth weight, congenital malformations, and neonatal resuscitation or NICU hospitalisation than those born to mothers from the French general population.

METHODOLOGY:

• Researchers conducted an observational study using data from the French National Health Data System to evaluate the effect of intrauterine exposure to uraemic toxins and maternal therapies on short- and mid-term health outcomes of children born to mothers on chronic dialysis.
• They included 70 liveborn children (median gestational age, 37 weeks; 45.7% girls), each born at a gestational age of at least 22 weeks and/or with a birth weight of at least 500 g.
• All mothers were receiving haemodialysis during pregnancy, with 46.4% receiving daily dialysis and 39.1% receiving conventional dialysis.
• Maternal, obstetric, and birth characteristics, along with neonatal complications and paediatric data from birth up to 8 years of age, were analysed; the median follow-up duration was 4.8 years.
• Neonatal outcomes of children born to mothers on chronic dialysis were compared with aggregated data of those born to mothers from the French general population using the 2021 French National Perinatal Survey.

TAKEAWAY:

• Neonatal complications in this cohort were respiratory distress syndrome (7.1%), small for gestational age (2.8%), congenital abnormalities (17.1%), early neonatal mortality (< 7 days; 4.2%), intraventricular haemorrhage (1.4%), and myoclonus (1.4%).
• Babies born to mothers receiving dialysis had significantly higher rates of prematurity (< 37 weeks; 42.9% vs 7%), low birth weight (< 2500 g; 45.7% vs 7.1%), neonatal resuscitation or NICU hospitalisation (18.5% vs 3%), and congenital abnormalities at birth (17.1% vs 0.7%) than those born to mothers from the general population (P < .0001 for all).
• From birth up to 8 years of age, the most common diseases observed in these children were respiratory diseases (44.2%), digestive diseases (31.4%), congenital malformations (24.2%), nervous system diseases (12.8%), and urinary diseases (10%).
• Neoplasms were identified in 4.2% of the children, including two cases of neuroblastoma and one case of retinoblastoma.

IN PRACTICE:

"The results of this study may help to raise awareness among physicians about the importance of fertility management in women on chronic dialysis, either through contraception, or by proper family planning to avoid surprise pregnancies," the authors wrote.

SOURCE:

This study was led by Hayet Baouche, APHP - Necker-Enfants Malades Hospital, REIN Registry, Paris, France. It was published online on March 20, 2026, in Nephrology Dialysis Transplantation.

LIMITATIONS:

The study database lacked detailed information on clinical and paraclinical data, reasons for consultation, children's developmental stages, and mothers' personal and family history. Additionally, the database sometimes captured only partial patient trajectories when patients had other health insurance plans.

DISCLOSURES:

No funding information was provided for the study. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.