Pregnancy Outcomes in Kidney Transplant Recipients

H. SHIRAKAWA¹, S. WAKAI², K. UNAGAMI³, K. OMOTO⁴, T. SHIMIZU⁴, Y. KAKUTA⁵, M. OKUMI⁵, H. ISHIDA⁵, M. OGAWA⁶, K. TANABE⁵

¹Urology, Ohkubo Hospital, Tokyo, Japan, ²Nephrology, Ohkubo Hospital, Tokyo, Japan, ³Nephrology, Tokyo Women's Medical University, Tokyo, Japan, ⁴Urology, Toda Central General Hospital, Saitama, Japan, ⁵Urology, Tokyo Women's Medical University, Tokyo, Japan, ⁶Obstetrics and Gynecology, Tokyo Women's Medical University, Tokyo, Japan

Meeting: 2019 American Transplant Congress

Abstract number: C59

Keywords: Hypertension, Kidney transplantation, Pregnancy

Topic:

Session Information

Session Name: Poster Session C: Kidney Complications: Late Graft Failure

Date: Monday, June 3, 2019

Session Time: 6:00pm-7:00pm

Presentation Time: 6:00pm-7:00pm

Location: Hall C & D

*Purpose: Kidney transplantation(KT) is often considered to be the best treatment increase the chance of pregnancy for women with chronic kidney disease(CKD). However, the pregnancy in KT has many risks which in particular are preterm delivery, small for gestational age babies, hypertensive disorders of pregnancy(HDP) and graft dysfunction. We retrospectively analyzed pregnancy outcomes after kidney transplantation.

*Methods: Ninety pregnancies in 83 KT recipients at Tokyo women’s medical university, Toda central hospital and Ohkubo hospital from 2001 to 2018 were analyzed retrospectively to identify outcomes of pregnancy after KT.

*Results: At pregnancy transplant mothers had a mean age of 34 years, a mean creatinine of 1.08 mg/dl and a functioning transplant for a mean of 6.7 years. The mean gestational age at birth was 34.5 weeks in transplant recipients, significantly shorter than the national average of 38 weeks (p<0.0001). Mean live birth weight for transplant recipients was 2230.3g which was lower than the national average (3000g).Preterm delivery at less than 37 weeks of gestation occurred in 44 cases (48.9%). HDP occurred in 43 cases (44.4%) and 24 cases of them were preeclampsia (26.7%). HDP (OR 5.63, CI 2.11-16.26) were significantly associated with increased risk of preterm delivery. Proteinuria prior to pregnancy (odds ratio: OR 3.50, 95% confidence interval: CI 0.62-29.63), hypertension prior to pregnancy (OR 0.78, CI 0.22-2.74) and serum creatinine (> or =1.5mg/dl) prior to pregnancy (OR 1.08, CI 0.14-10.24) were not significant.

*Conclusions: In this study, HDP was related to the occurrence of preterm delivery in kidney transplant pregnancies.Although transplant pregnancies were generally successful, outcomes differed from the general population, indicatingthese remain high-risk pregnancies despite good allograft function.

To cite this abstract in AMA style:

SHIRAKAWA H, WAKAI S, UNAGAMI K, OMOTO K, SHIMIZU T, KAKUTA Y, OKUMI M, ISHIDA H, OGAWA M, TANABE K. Pregnancy Outcomes in Kidney Transplant Recipients [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/pregnancy-outcomes-in-kidney-transplant-recipients/. Accessed June 13, 2021.

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