Pregnancy outcomes and impact of pregnancy on graft function in women after kidney transplantation

Background Kidney transplantation facilitates pregnancy in women with end‐stage kidney disease; however, the impact of pregnancy on short and longer‐term graft function is uncertain. Methods Obstetric, fetal, and graft outcomes for pregnancies from a large Australian transplant unit (1976‐2015) were...

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Bibliographic Details
Published in:Clinical transplantation 2017-10, Vol.31 (10), p.n/a
Main Authors: Mohammadi, F.A., Borg, M., Gulyani, A., McDonald, S.P., Jesudason, S.
Format: Article
Language:English
Subjects:
Adult
creatinine
Female
Follow-Up Studies
Gestational Age
Glomerular Filtration Rate
Graft Survival
Humans
Infant, Newborn
kidney
Kidney Failure, Chronic - physiopathology
Kidney Failure, Chronic - surgery
Kidney Function Tests
Kidney Transplantation
Pregnancy
Pregnancy Complications - epidemiology
Pregnancy Outcome - epidemiology
Prognosis
Risk Factors
tacrolimus
transplantation
Young Adult
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Summary:Background Kidney transplantation facilitates pregnancy in women with end‐stage kidney disease; however, the impact of pregnancy on short and longer‐term graft function is uncertain. Methods Obstetric, fetal, and graft outcomes for pregnancies from a large Australian transplant unit (1976‐2015) were reviewed. Results There were 56 pregnancies in 35 women with mean age at conception 30.4 ± 0.6 years and mean transplant‐pregnancy interval 5.5 ± 0.5 years. The live birth rate was 78.9%. Preterm birth ( 110 μmol/L had increased risk of pre‐eclampsia (OR 4.4; 95% CI 1.2‐16.8; P = .03), but not preterm birth (OR 5.4; 95% CI 0.5‐53; P = .04) or low birth‐weight babies (OR 1.2; 95% CI 0.5‐2.9; P = .04). Women with SCr > 140 μmol/L preconception had worst SCr trajectory, including higher rates of graft loss. Conclusions Kidney transplantation pregnancies remain at high risk of obstetric complications, particularly pre‐eclampsia. Prepregnancy graft function can be used to predict risk of adverse pregnancy outcomes and deterioration in graft function during and after delivery.
ISSN:0902-0063
1399-0012
DOI:10.1111/ctr.13089