*Purpose: The purpose of this study is to compare pregnancy outcomes in 1066 female kidney transplant recipients by different conception ages.

*Methods: Data were collected by the Transplant Pregnancy Registry International (TPR), a voluntary pregnancy registry using questionnaires, telephone interviews, and medical records review. Maternal, fetal, and transplant outcomes were compared by different conception ages.

*Results: Shown in Table 1 are the results of the analyses.

With increasing maternal age, the likelihood of planned pregnancy increased along with lower fetal exposure to mycophenolic acid products. The termination rate was the lowest while the miscarriage rate was highest in the older age group. Rates of HTN and preeclampsia were similar among the age groups, but the older recipients had a significantly higher rate of diabetes. With younger age there were significantly higher rates of rejection during pregnancy and postpartum, higher serum creatinine post pregnancy, and a higher rate of graft loss within 2 years of pregnancy. Live birth rates, gestational age, and birth weight were similar among all age groups.

*Conclusions: Except for higher rate of miscarriages the older kidney transplant recipients tolerated pregnancy well and the newborn outcomes were comparable with younger recipients. The poorer transplant outcomes in the younger recipients including higher rejection and graft loss are alarming. The high rate of unplanned pregnancy in this age group is a modifiable factor. Efforts to address reproductive health and contraception counseling in all female transplant recipients of child bearing potential are warranted.

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