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Pregnancy outcome post renal transplantation
Michael D Sgro1, Tony Barozzino, Hisham M Mirghani
1Department of Pediatrics, Mount Sinai Hospital, The University of Toronto, Toronto, Ontario, Canada.
Teratology
|February 9, 2002
Summary
Pregnancies after kidney transplants show higher risks of stillbirths, preterm birth, and low birth weight. However, most children born to these mothers experience normal growth and development, warranting further long-term studies.
Area of Science:
- Nephrology
- Reproductive Medicine
- Pediatric Follow-up
Background:
- Successful organ transplantation improves life expectancy and quality of life for recipients.
- Transplant recipients reaching reproductive age face challenges regarding teratogenicity and immunosuppressive drug effects.
- Previous studies indicate risks for mother and fetus in pregnancies post-renal transplantation.
Purpose of the Study:
- To evaluate prenatal and long-term postnatal outcomes of pregnancies after renal transplantation.
- To assess the effects of immunosuppressive medications on children born to renal transplant recipients.
- To compare outcomes with a control group matched for maternal age and smoking status.
Main Methods:
- Retrospective case series of 44 consecutive pregnancies managed by the Toronto Renal Transplant Program.
- Follow-up data collected for 32 live-born children via clinic visits or telephone interviews.
- Medical and developmental information gathered and compared to matched controls from the Motherisk Program.
Main Results:
- 32 live births and 12 stillbirths/abortuses from 44 pregnancies.
- Significantly lower gestational age (36.5 weeks) and birthweight (2.54 kg) in the transplant group compared to controls (40.2 weeks, 3.59 kg).
- Increased incidence of stillbirths (4 vs 0), multiple anomalies (1 vs 0), and later developmental issues (hearing loss, learning disability) in the study group.
Conclusions:
- Pregnancies after renal transplantation are associated with higher rates of stillbirths, preterm delivery, and low birth weight.
- Despite risks, most offspring exhibit normal postnatal growth and development.
- Long-term pediatric follow-up is crucial to understand potential effects of immunosuppressive medications on growth, development, and overall health.