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Pregnancy Outcomes in Female Kidney Transplant Recipients: Does Ethnicity Have an Influence?

S. Constantinescu,1,2 L. Coscia,2 D. Armenti,2 P. Axelrod,1 M. Ghanta,1 S. Rao,1 M. Moritz.2,3

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
*Chi2 or ANOVA; # p<0.05 compared to each other group; NS=not significant

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.

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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 May 16, 2025.

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