Outcomes of Subsequent Pregnancies in Female Heart Transplant Recipients
1Transplant Pregnancy Registry International, Gift of Life Institute, Philadelphia, PA
2Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA
3Surgery, Lehigh Valley Health Network, Allentown, PA
4Surgery, Morsani College of Medicine, Tampa, FL.
Meeting: 2018 American Transplant Congress
Abstract number: B48
Keywords: Heart transplant patients, Pregnancy, Quality of life
Session Information
Session Name: Poster Session B: Heart and VADs: All Topics
Session Type: Poster Session
Date: Sunday, June 3, 2018
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
The purpose of this study is to analyze the maternal and newborn outcomes in successive pregnancies in female heart transplant recipients (HT) reported to the Transplant Pregnancy Registry International. 91 HT reported 153 pregnancies with 158 outcomes, including twins and triplets. Of these, 39 females had 1 or more subsequent pregnancies.
| Pregnancy Outcomes in Heart Transplant Recipients | |||
| First Pregnancy | Subsequent Pregnancies | p-value# | |
| Recipients/Pregnancies/Outcomes | 91/91/94 | 39/62/64 | |
| PREGNANCY OUTCOMES | |||
| Miscarriages | 24% | 36% | NS |
| – Miscarriages with MPA product exposure | 52% | 34% | |
| Termination | 6% | 2% | |
| Ectopic | 0 | 3% | |
| Stillbirth | 1% | 0 | |
| LIVE BIRTHS, n (%) | 64 (68%) | 43 (67%) | |
| – Live births with MPA product exposure | 16% | 12% | |
| Gestational age*, wks | 36.6 ± 2.8 | 35.6 ± 4.1 | |
| Premature, <37 wks | 39% | 49% | |
| Birth Weight*, g | 2633±582 | 2497±819 | |
| Birth Defects | 6% | 12% | |
| Inherited mother's disease | 6% | 7% | |
| MATERNAL OUTCOMES | |||
| Rejection during pregnancy | 9% | 10% | NS |
| Rejection postpartum | 4% | 13% | |
| Graft loss within 2 yrs postpartum | 1% | 3% | |
| #chi2 or t-test, MPA=mycophenolic acid,*mean ± SD | |||
With successive pregnancies the proportion of live births, premature infants and birth weight remained unchanged. Up to 13% HT had rejection during pregnancy or postpartum, but none of these rejections were associated with graft loss within 2 yrs postpartum. MPA exposure during pregnancy was reported in 43% (20/46) of all miscarriages, and 3 birth defects were attributed to MPA embryopathy.
Conclusions: Successive pregnancies in HT are not associated with adverse fetal outcomes or increased maternal graft loss. Rate of live births, preterm delivery, potentially inheritable heart disease and gestation-associated rejection remain unaffected with subsequent pregnancies. Female HT of childbearing age should be counseled regarding family planning, teratogenicity of MPA, fetal risks and maternal survival.
CITATION INFORMATION: Rao S., Armenti D., Coscia L., Constantinescu S., Moritz M. Outcomes of Subsequent Pregnancies in Female Heart Transplant Recipients Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:
Rao S, Armenti D, Coscia L, Constantinescu S, Moritz M. Outcomes of Subsequent Pregnancies in Female Heart Transplant Recipients [abstract]. https://atcmeetingabstracts.com/abstract/outcomes-of-subsequent-pregnancies-in-female-heart-transplant-recipients/. Accessed November 21, 2024.« Back to 2018 American Transplant Congress