title: Obstetric and long-term kidney outcomes in renal transplant recipients: a 40-yr single-center study.
abstract: Female renal transplant recipients of childbearing age may ask what the outcomes are for pregnancy and whether pregnancy will affect graft function. We analyzed obstetric and transplant outcomes among renal transplant recipients in our center who have been pregnant between 1973 and 2013. A case-cohort study was performed identifying 83 pairs of pregnant and non-pregnant controls matched for sex, age, transplant vintage, and creatinine. There were 138 pregnancies reported from 89 renal transplant recipients. There were live births in 74% of pregnancies with high prevalence of prematurity (61%), low birth weight (52%), and pre-eclampsia (14%). Lower eGFR (OR 0.98; p = 0.05) and higher uPCR (OR 1.86; p = 0.02) at conception were independent predictors for poor composite obstetric outcome. Lower eGFR (OR 0.98; p = 0.04), higher uPCR (OR 1.50; p = 0.04), and live organ donation (OR 0.35; p = 0.02) were predictors of ≥20% loss of eGFR between immediately pre-pregnancy and one yr after delivery. There was no difference in eGFR at one, five, and 10 yr in pregnant women compared with non-pregnant controls and a pregnancy was not associated with poorer 10-yr transplant or 20-yr patient survival. Despite high rates of obstetric complications, most women had successful pregnancies with good long-term transplant function.
authors.affiliation: The Glasgow Renal & Transplant Unit, Queen Elizabeth University Hospital, Glasgow, UK.
authors.forename: Sokratis
authors.initials: S
authors.lastname: Stoumpos
authors.affiliation: The Glasgow Renal & Transplant Unit, Queen Elizabeth University Hospital, Glasgow, UK.
authors.forename: Susan H
authors.initials: SH
authors.lastname: McNeill
authors.affiliation: The Glasgow Renal & Transplant Unit, Queen Elizabeth University Hospital, Glasgow, UK.
authors.forename: Morag
authors.initials: M
authors.lastname: Gorrie
authors.affiliation: The Glasgow Renal & Transplant Unit, Queen Elizabeth University Hospital, Glasgow, UK.|Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.
authors.forename: Patrick B
authors.initials: PB
authors.lastname: Mark
authors.affiliation: Department of Obstetrics, Queen Elizabeth University Hospital, Glasgow, UK.
authors.forename: Janet E
authors.initials: JE
authors.lastname: Brennand
authors.affiliation: The Glasgow Renal & Transplant Unit, Queen Elizabeth University Hospital, Glasgow, UK.
authors.forename: Colin C
authors.initials: CC
authors.lastname: Geddes
authors.affiliation: The Glasgow Renal & Transplant Unit, Queen Elizabeth University Hospital, Glasgow, UK.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Deighan
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D036861:Delivery, Obstetric / Q000706:statistics & numerical data*; D005260:Female; D006085:Graft Survival; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007668:Kidney / Q000503:physiopathology*; D016030:Kidney Transplantation; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D066027:Transplant Recipients; D006113:United Kingdom / Q000453:epidemiology
keywords: kidney transplant; obstetric; pregnancy; transplant outcomes