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Pregnancy Outcomes in Kidney Recipients With Longer Transplant to Conception Intervals

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 Heath Network, Allentown.

Meeting: 2015 American Transplant Congress

Abstract number: 386

Keywords: 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: 2:39pm-2:51pm

Location: Room 119-B

The purpose of this study was to analyze pregnancy outcomes in female kidney transplant recipients with transplant to conception intervals (TCI) after the recommended 2 yr wait period posttransplant. Data were collected by the National Transplantation Pregnancy Registry (NTPR) via questionnaires, telephone interviews, and hospital records. We analyzed the first pregnancy in 572 recipients conceived between 2-5, 5-10, or >10 yrs posttransplant.

TRANSPLANT TO CONCEPTION INTERVAL Range (mean±SD) 2 to < 5 yrs (3.3±0.9 yrs) 5 to < 10 yrs (6.9±1.4 yrs) > 10 yrs (13.3±3 yrs) p-value**
Recipients/Pregnancies 320/320 168/168 84/84  
MATERNAL FACTORS        
Pretransplant pregnancy 32%# 14%# 5%# <0.001
Age at first transplant (yrs) 24.6±5.9 21.9±5.2 17.4±5.6# <0.001
Age at posttransplant conception 28.8±5.4 29.2±5.2 30.9±5.6# 0.003
Planned pregnancy 62% 71% 64% NS
Pregnancy after 2 or more transplants 15% 11% 6% 0.048
Living donor 57% 52% 72%# 0.012
Diabetes during pregnancy 8% 10% 9% NS
Hypertension during pregnancy 57% 54% 40%# 0.028
Preeclampsia 33% 33% 40% NS
Creatinine before pregnancy (mg/dL) 1.28±0.4 1.23±0.4 1.28±0.4 NS
Creatinine during pregnancy (mg/dL) 1.38±0.7 1.32±0.7 1.39±0.5 NS
Creatinine postpartum (mg/dL) 1.47±0.8 1.34±0.6 1.4±0.7 NS
Acute rejection during pregnancy 1% 1% 0 NS
Graft loss within 2 yrs of pregnancy 7% 6% 5% NS
PREGNANCY OUTCOMES* n=330 n=173 n=88  
Miscarriages 10% 12% 8% NS
Termination of pregnancy 2% 2% 2% NS
Ectopic 1% 1% 0 NS
Stillbirths 2% 2% 2% NS
Live births (n) 85% (280) 83% (143) 88% (77) NS
Mean gestational age (wks) 35.4±4.0 36.2±2.9 35.9±3.6 NS
Premature (<37 wks) 54% 53% 48% NS
Mean birthweight (g) 2475±817 2659±723# 2429±811 0.03
Low birthweight (<2500 g) 44% 39% 51% NS
Neonatal deaths n=5 n=0 n=0 NS
Birth defects 3.6% 8.4% 3.9% NS
*Includes multiple births;**Chi2 or ANOVA; # p<0.05 compared to each other group

The TCI >10 group was transplanted at a significantly younger age, conceived at an older age, and had less HTN during pregnancy. Graft function during pregnancy and postpartum was similar among the groups, as were pregnancy outcomes.

Conclusions: Reports to NTPR do not reveal significant differences in outcomes of pregnancies in kidney recipients who conceive after 2yrs, 5yrs or 10 yrs posttransplant. Kidney recipients should not be discouraged from conceiving based on longer TCI.

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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 Kidney Recipients With Longer Transplant to Conception Intervals [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/pregnancy-outcomes-in-kidney-recipients-with-longer-transplant-to-conception-intervals/. Accessed May 9, 2025.

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