Pregnancy and maternal outcomes among kidney transplant recipients.
Fertility rates, pregnancy, and maternal outcomes are not well described among women with a functioning kidney transplant. Using data from the Australian and New Zealand Dialysis and Transplant Registry, we analyzed 40 yr of pregnancy-related outcomes for transplant recipients. This analysis included 444 live births reported from 577 pregnancies; the absolute but not relative fertility rate fell during these four decades. Of pregnancies achieved, 97% were beyond the first year after transplantation. The mean age at the time of pregnancy was 29 +/- 5 yr. Compared with previous decades, the mean age during the last decade increased significantly to 32 yr (P < 0.001). The proportion of live births doubled during the last decade, whereas surgical terminations declined (P < 0.001). The fertility rate (or live-birth rate) for this cohort of women was 0.19 (95% confidence interval 0.17 to 0.21) relative to the Australian background population. We also matched 120 parous with 120 nulliparous women by year of transplantation, duration of transplant, age at transplantation +/-5 yr, and predelivery creatinine for parous women or serum creatinine for nulliparous women; a first live birth was not associated with a poorer 20-yr graft or patient survival. Maternal complications included preeclampsia in 27% and gestational diabetes in 1%. Taken together, these data confirm that a live birth in women with a functioning graft does not have an adverse impact on graft and patient survival.
Australian and New Zealand Dialysis and Transplant (ANZDATA) Registry, Adelaide, South Australia, Australia. vicki.levidiotis@wh.org.au
Vicki
V
Levidiotis
Sean
S
Chang
Stephen
S
McDonald
D000293:Adolescent; D000328:Adult; D001723:Birth Rate; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008875:Middle Aged; D011247:Pregnancy / Q000706:statistics & numerical data; D011256:Pregnancy Outcome; D055815:Young Adult