Maternal Peripartum Complications in Solid Organ Transplantation

R. X. Wang¹, G. S. Lee-Riddle², D. O. Walls³, D. S. Goldberg⁴, P. L. Abt²

¹Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, ²Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, ³Department of Surgery, Robert Wood Johnson University Hospital, New Brunswick, NJ, ⁴Department of Medicine, University of Miami Miller School of Medicine, Miami, FL

Meeting: 2020 American Transplant Congress

Abstract number: B-149

Keywords: Kidney transplantation, Liver transplantation, Pregnancy

Session Information

Session Name: Poster Session B: Liver Retransplantation and Other Complications

Session Type: Poster Session

Date: Saturday, May 30, 2020

Session Time: 3:15pm-4:00pm

Presentation Time: 3:30pm-4:00pm

Location: Virtual

*Purpose: Previous studies examining pregnancy related complications after solid organ transplantation (SOT) primarily relied on voluntary registries and meta-analyses. Herein, we investigated maternal delivery outcomes after SOT in a multistate cohort.

*Methods: We performed a retrospective cohort analysis of inpatient deliveries using Healthcare Cost and Utilization Project datasets from California (2005-2011), New York (2010-2013), and Florida (2005-2014). Multivariable logistic regression models were developed to compare peripartum complications of kidney and liver recipients with non-SOT women.

*Results: There were 339 deliveries from kidney recipients with median maternal age of 32 (28-36). Liver recipients had 163 deliveries with median maternal age at 27 (22-32). Non-SOT women had 5,650,795 deliveries with median maternal age of 28 (23-33). 86% of kidney recipients and 78% of liver recipients had one delivery. Kidney recipients were at increased risk for complications such as labor complications (OR: 3.75, 95% CI: 3.03-4.64, p<0.001), peripartum hemorrhage (OR: 2.21, 95% CI: 1.55-3.17, p<0.001), pregnancy related hypertensive disorders (OR: 8.91, 95% CI: 7.15-11.09, p<0.001), membrane-related disorders, including premature rupture of membranes and oligohydramnios, (OR: 1.64, 95% CI: 1.22-2.21, p=0.001), and caesarean section (OR: 2.65, 95% CI: 2.12-3.32, p<0.001) compared to non-SOT women. Liver recipients were also at increased risk for complications including labor complications (OR: 1.70, 95% CI: 1.21-2.39, p=0.002), peripartum hemorrhage (OR: 3.61, 95% CI: 2.29-5.70, p<0.001), pregnancy related hypertensive disorders (OR: 4.38, 95% CI: 3.06-6.27, p<0.001), and caesarean section (OR: 2.00, 95% CI: 1.46-2.73, p<0.001) compared to non-SOT women.

*Conclusions: Our results demonstrate an increased risk of delivery complications in SOT recipients. Additional research is needed to study the short and long-term neonatal outcomes of babies born to SOT mothers as well as the effect of pregnancy on graft survival and rejection to better characterize the relationships between pregnancy and transplantation.

To cite this abstract in AMA style:

Wang RX, Lee-Riddle GS, Walls DO, Goldberg DS, Abt PL. Maternal Peripartum Complications in Solid Organ Transplantation [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/maternal-peripartum-complications-in-solid-organ-transplantation/. Accessed May 11, 2025.

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