Pregnancy Outcomes in Kidney Recipients With Longer Transplant to Conception Intervals
1Temple University School of Medicine, Philadelphia
2National Transplantation Pregnancy Registry, Gift of Life Institute, Philadelphia
3Lehigh Valley Heath Network, Allentown.
Meeting: 2015 American Transplant Congress
Abstract number: 386
Keywords: Kidney transplantation, Pregnancy, Quality of life
Session Information
Session Name: Concurrent Session: Kidney: Pregnancy, Metabolic Complications, Malignancy
Session Type: Concurrent Session
Date: Tuesday, May 5, 2015
Session Time: 2:15pm-3:45pm
Presentation Time: 2:39pm-2:51pm
Location: Room 119-B
The purpose of this study was to analyze pregnancy outcomes in female kidney transplant recipients with transplant to conception intervals (TCI) after the recommended 2 yr wait period posttransplant. Data were collected by the National Transplantation Pregnancy Registry (NTPR) via questionnaires, telephone interviews, and hospital records. We analyzed the first pregnancy in 572 recipients conceived between 2-5, 5-10, or >10 yrs posttransplant.
| TRANSPLANT TO CONCEPTION INTERVAL Range (mean±SD) | 2 to < 5 yrs (3.3±0.9 yrs) | 5 to < 10 yrs (6.9±1.4 yrs) | > 10 yrs (13.3±3 yrs) | p-value** |
| Recipients/Pregnancies | 320/320 | 168/168 | 84/84 | |
| MATERNAL FACTORS | ||||
| Pretransplant pregnancy | 32%# | 14%# | 5%# | <0.001 |
| Age at first transplant (yrs) | 24.6±5.9 | 21.9±5.2 | 17.4±5.6# | <0.001 |
| Age at posttransplant conception | 28.8±5.4 | 29.2±5.2 | 30.9±5.6# | 0.003 |
| Planned pregnancy | 62% | 71% | 64% | NS |
| Pregnancy after 2 or more transplants | 15% | 11% | 6% | 0.048 |
| Living donor | 57% | 52% | 72%# | 0.012 |
| Diabetes during pregnancy | 8% | 10% | 9% | NS |
| Hypertension during pregnancy | 57% | 54% | 40%# | 0.028 |
| Preeclampsia | 33% | 33% | 40% | NS |
| Creatinine before pregnancy (mg/dL) | 1.28±0.4 | 1.23±0.4 | 1.28±0.4 | NS |
| Creatinine during pregnancy (mg/dL) | 1.38±0.7 | 1.32±0.7 | 1.39±0.5 | NS |
| Creatinine postpartum (mg/dL) | 1.47±0.8 | 1.34±0.6 | 1.4±0.7 | NS |
| Acute rejection during pregnancy | 1% | 1% | 0 | NS |
| Graft loss within 2 yrs of pregnancy | 7% | 6% | 5% | NS |
| PREGNANCY OUTCOMES* | n=330 | n=173 | n=88 | |
| Miscarriages | 10% | 12% | 8% | NS |
| Termination of pregnancy | 2% | 2% | 2% | NS |
| Ectopic | 1% | 1% | 0 | NS |
| Stillbirths | 2% | 2% | 2% | NS |
| Live births (n) | 85% (280) | 83% (143) | 88% (77) | NS |
| Mean gestational age (wks) | 35.4±4.0 | 36.2±2.9 | 35.9±3.6 | NS |
| Premature (<37 wks) | 54% | 53% | 48% | NS |
| Mean birthweight (g) | 2475±817 | 2659±723# | 2429±811 | 0.03 |
| Low birthweight (<2500 g) | 44% | 39% | 51% | NS |
| Neonatal deaths | n=5 | n=0 | n=0 | NS |
| Birth defects | 3.6% | 8.4% | 3.9% | NS |
The TCI >10 group was transplanted at a significantly younger age, conceived at an older age, and had less HTN during pregnancy. Graft function during pregnancy and postpartum was similar among the groups, as were pregnancy outcomes.
Conclusions: Reports to NTPR do not reveal significant differences in outcomes of pregnancies in kidney recipients who conceive after 2yrs, 5yrs or 10 yrs posttransplant. Kidney recipients should not be discouraged from conceiving based on longer TCI.
To cite this abstract in AMA style:
Constantinescu S, Coscia L, Armenti D, Axelrod P, Ghanta M, Rao S, Moritz M. Pregnancy Outcomes in Kidney Recipients With Longer Transplant to Conception Intervals [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/pregnancy-outcomes-in-kidney-recipients-with-longer-transplant-to-conception-intervals/. Accessed November 22, 2024.« Back to 2015 American Transplant Congress