title: Intrauterine hypotrophy and premature births in neonates delivered by female renal and liver transplant recipients.
abstract: BACKGROUND
  Neonates born to mothers, who underwent organ transplantation require close medical monitoring. It is unknown how chronically diseased mother's organs or immunosuppressive drugs affect fetal growth and development; some immunosuppressants are teratogenic and contraindicated during pregnancy. The aim of this study was to determine the prevalence of prematurity and intrauterine growth restriction in neonates born to women who have undergone renal or liver transplantation.
  
  
  METHODS
  Our retrospective analysis identified 53 (25 renal and 28 liver) cases of neonates delivered by female graft recipients between January 2005 and December 2009. Hypotrophy was defined as a birth weight<10th percentile for gestational age. We excluded newborns diagnosed with severe hypotrophy (<5th percentile).
  
  
  RESULTS
  Neonates born prematurely were predominate in the renal (16/25, 64%), but less than half of the liver cohort (13/28, 46%). Hypotrophy less than the 10th percentile was noted significantly more often among renal than liver recipients; 36% versus 14% (P<.05). Severe hypotrophy was also observed significantly more often among renal than liver transplant neonates: 28% versus 3.6% (P<.001).
  
  
  CONCLUSIONS
  Compared with liver insufficiency, chronic kidney diseases have stronger effects on the fetus, leading to adverse neonatal complications. A greater prevalence of preterm births, as well as hypotrophic newborns, especially less than the 5th percentile, was observed among neonates delivered by mothers after kidney transplantation.
authors: Neonatal Ward, The 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland. bnajman@wp.pl
authors: B
authors: B
authors: Kociszewska-Najman
authors: B
authors: B
authors: Pietrzak
authors: A
authors: A
authors: Cyganek
authors: M
authors: M
authors: Szpotanska-Sikorska
authors: J
authors: J
authors: Schreiber-Zamora
authors: Z
authors: Z
authors: Jabiry-Zieniewicz
authors: M
authors: M
authors: Wielgos
mesh_terms: D001724:Birth Weight; D005260:Female; D005317:Fetal Growth Retardation / Q000209:etiology*; D006801:Humans; D006973:Hypertension / Q000209:etiology; D007166:Immunosuppressive Agents / Q000009:adverse effects; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D016030:Kidney Transplantation / Q000009:adverse effects*; D016031:Liver Transplantation / Q000009:adverse effects*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology*; D011249:Pregnancy Complications, Cardiovascular / Q000209:etiology; D047928:Premature Birth / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D007166:Immunosuppressive Agents