Pregnancy Outcomes in Female Kidney Transplant Recipients: Does Ethnicity Have an Influence?
1Temple University School of Medicine, Philadelphia
2National Transplantation Pregnancy Registry, Gift of Life Institute, Philadelphia
3Lehigh Valley Health Network, Allentown.
Meeting: 2015 American Transplant Congress
Abstract number: 385
Keywords: African-American, 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: 2:27pm-2:39pm
Location: Room 119-B
The purpose of this study was to analyze pregnancy outcomes in female kidney transplant recipients by ethnicity. Data were collected by the National Transplantation Pregnancy Registry via questionnaires, phone interviews and hospital records. 811 recipients were separated into four groups.
| CAUCASIAN | HISPANIC | AFRICAN-AMERICAN (AA) | ASIAN | p-value* | |
| Recipients/Pregnancies | 615/1180 | 91/133 | 72/111 | 33/58 | |
| MATERNAL FACTORS | |||||
| Age at conception | 29±5.4 | 28.7±5.3 | 29.1±5 | 31.1±4.6 | 0.005 |
| Transplant to conception interval (yrs) | 4.3±3.8 | 4.6±3.9 | 3.6±3.9 | 4.2±3.2 | NS |
| Planned pregnancy | 64% | 50% | 32%# | 60% | <0.001 |
| Living donor | 62% | 51% | 50% | 48% | 0.002 |
| Diabetes before pregnancy | 4% | 4% | 7% | 4% | NS |
| Diabetes during pregnancy | 7% | 10% | 7% | 14% | NS |
| Hypertension before pregnancy | 41%# | 51% | 70% | 61% | <0.001 |
| Hypertension during pregnancy | 47% | 57% | 68% | 60% | <0.001 |
| Preeclampsia | 30% | 32% | 19% | 27% | NS |
| Creatinine before pregnancy (mg/dL) | 1.3±0.4 | 1.2±0.4 | 1.4±0.5 | 1.2±0.3 | NS |
| Creatinine during pregnancy (mg/dL) | 1.3±0.7 | 1.3±0.6 | 1.6±0.8# | 1.3±0.5 | <0.001 |
| Creatinine postpartum (mg/dL) | 1.4±0.7 | 1.3±0.7 | 1.8±1.2# | 1.4±0.5 | <0.001 |
| Biopsy-proven acute rejection during pregnancy | 1% | 1% | 3% | 0 | NS |
| Graft loss within 2 yrs of pregnancy | 5% | 6% | 13% | 2% | <0.001 |
| PREGNANCY OUTCOMES | |||||
| Miscarriages | 18% | 16% | 11% | 15% | NS |
| Termination of pregnancy | 3% | 3% | 7% | 3% | NS |
| Ectopic | 1% | 1% | 2% | 0 | NS |
| Stillbirths | 2% | 1% | 0 | 2% | NS |
| Live births | 75% (n=922) | 79% (n=107) | 80% (n=93) | 80% (n=47) | NS |
| Mean gestational age (wks) | 36.1±3.3 | 35.7±3.2 | 35.1±3.9 | 35.4±3.7 | <0.001 |
| Premature (< 37 wks) | 47% | 57% | 55% | 57% | 0.05 |
| Mean birthweight (g) | 2648±736 | 2536±756 | 2264±826 | 2349±827 | <0.001 |
| Low birthweight (<2500 g) | 38%# | 49% | 53% | 57% | <0.001 |
| Birth defects | 5.2% | 4.7% | 2.2% | 2.1% | NS |
AA have significantly fewer planned pregnancies, more HTN, significantly increased creatinine during pregnancy and post-partum, and increased graft loss within 2 yrs after delivery. Compared to all groups, Caucasians have significantly less HTN, longer mean gestational age, and significantly fewer low birthweight babies.
Conclusions: There are notable ethnic differences in pregnancy outcomes among female kidney transplant recipients. Kidney graft dysfunction during and after pregnancy is significantly more common in AA recipients thus closer observation may be warranted in this population.
To cite this abstract in AMA style:
Constantinescu S, Coscia L, Armenti D, Axelrod P, Ghanta M, Rao S, Moritz M. Pregnancy Outcomes in Female Kidney Transplant Recipients: Does Ethnicity Have an Influence? [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/pregnancy-outcomes-in-female-kidney-transplant-recipients-does-ethnicity-have-an-influence/. Accessed November 21, 2024.« Back to 2015 American Transplant Congress