Obstetrical and Perinatal Outcomes of Posttransplant Pregnancy in Kidney and Liver Transplant Recipients

Pregnancy after transplant still confers increased risks of various complications. This study analyzed obstetrical and perinatal outcomes of posttransplant pregnancy in kidney and liver transplant recipients.

We included kidney and liver transplant recipients with posttransplant pregnancy who were followed in our institution from 2011 to 2025. Patients were monitored simultaneously in the transplant outpatient clinic and obstetrics and gynecology clinics. We retrospectively analyzed the obstetrical complications, perinatal outcomes, and the effect of pregnancy on allograft function.

We analyzed 18 kidney and 13 liver transplant recipients with posttransplant pregnancy. Mean mater-nal age of kidney transplant recipients was 31.1 years at the birth of the child. In the kidney transplant group, 7 patients (35 % ) delivered live birth at term, 7 patients (35 % ) experienced pregnancy complications of ges-tational hypertension or preeclampsia, and 1 patient experienced graft rejection during the postpartum period. In the liver transplant group, 8 patients (61.5 % ) delivered live birth at term. One patient had intrahepatic cholestasis of pregnancy, 1 patient had preterm premature rupture of membranes, 1 patient had preeclampsia, and 1 patient had gestational diabetes. There were no graft rejections in the liver transplant group. Mean maternal age and rate of nulliparity were higher in the kidney transplant versus the liver transplant group (P = . ⁰³² and P = . ⁰¹³, respectively ). No significant differences were shown for gestational age at delivery, preterm birth rate, birth weights of the newborns, and rates of neonatal intensive care unit hospitalizations.

Pregnancy after solid -organ transplant is associated with potential risks for the mother, newborn, and the allograft. We observed higher rates of adverse obstetrical outcomes in the kidney transplant group versus the liver transplant group. We believe that a multidisciplinary approach during the antenatal and postpartum periods is essential to improve outcomes and minimize complications.