title: Obstetric and neonatal outcome of pregnancies fathered by males on immunosuppression after solid organ transplantation.
abstract: Immunosuppressive drugs may influence spermatogenesis, but little is known about outcome of pregnancies fathered by transplanted males. We estimated risk of adverse outcomes in pregnancies (with data after the first trimester) fathered by males that had undergone organ transplantation and were treated with immunosuppression. A population-based study, linking data from the Norwegian transplant registry and the Medical Birth Registry of Norway during 1967-2009 was designed. All Norwegian men undergoing solid organ transplantation were included. Odds ratios for major malformations, preeclampsia, preterm delivery (<37 weeks) and small-for-gestational-age were obtained using logistic regression. A total of 2463 transplanted males, fathering babies of 4614 deliveries before and 474 deliveries after transplantation were identified. The risk of preeclampsia was increased (AOR: 7.4, 95% CI: 1.1-51.4,) after transplantation compared to prior to transplantation. No increased risk was found for congenital malformations or other outcomes when compared with pregnancies before transplantation or with the general population (2 511 506 births). Our results indicate an increased risk of preeclampsia mediated through the transplanted and immunosuppressed father. Importantly, no increased risk was found for other adverse obstetric outcomes or malformations, which may reassure male transplant recipients planning to father children.
authors: Department of Clinical Sciences, University of Bergen, Norway.|Department of Global Public Health and Primary Care, University of Bergen, Norway.|Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway.
authors: N-H
authors: NH
authors: Morken
authors: Department of Gynecology and Obstetrics, La Fe University Hospital and Instituto de Investigación Sanitaria La Fe, University of Valencia, Spain.
authors: C
authors: C
authors: Diaz-Garcia
authors: The Norwegian Renal Registry, Oslo, Norway.
authors: A V
authors: AV
authors: Reisaeter
authors: Department of Transplantation Medicine, Rikshospitalet, Oslo University Hospital, Norway.
authors: A
authors: A
authors: Foss
authors: The Norwegian Renal Registry, Oslo, Norway.
authors: T
authors: T
authors: Leivestad
authors: Institute of Clinical Medicine, University of Oslo, Norway.|Department of Cardio-Thoracic Surgery, Rikshospitalet, Oslo University Hospital, Norway.
authors: O
authors: O
authors: Geiran
authors: Biostatistics Unit, Instituto de Investigación Sanitaria La Fe, University of Valencia, Spain.
authors: D
authors: D
authors: Hervás
authors: Department of Obstetrics & Gynecology, Sahlgrenska Academy, University of Gothenburg, Sweden.
authors: M
authors: M
authors: Brännström
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D000013:Congenital Abnormalities / Q000453:epidemiology*; D005220:Fathers / Q000706:statistics & numerical data*; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control; D016027:Heart Transplantation / Q000009:adverse effects / Q000706:statistics & numerical data; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000009:adverse effects / Q000706:statistics & numerical data; D016031:Liver Transplantation / Q000009:adverse effects / Q000706:statistics & numerical data; D016040:Lung Transplantation / Q000009:adverse effects / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D016377:Organ Transplantation / Q000009:adverse effects* / Q000706:statistics & numerical data*; D011225:Pre-Eclampsia / Q000453:epidemiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome / Q000453:epidemiology*; D047928:Premature Birth / Q000453:epidemiology*; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D013091:Spermatogenesis / Q000187:drug effects; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents
keywords: clinical research/practice; health services and outcomes research; immunosuppressant; obstetrics and gynecology; pregnancy