Pregnancy After Kidney Transplantation

Transplant Proc. 2021 Apr;53(3):1080-1084. doi: 10.1016/j.transproceed.2020.11.003. Epub 2020 Dec 25.

Abstract

Background: Pregnancy after kidney transplantation is an uncommon event. In addition to the risk to the child and the mother, pregnancy has a certain risk for the transplanted kidney.

Methods: We made a retrospective analysis of pregnancy and kidney function over a 49-year period in women with transplanted kidneys monitored at the National Transplant Centre, University Medical Centre Ljubljana, Ljubljana, Slovenia.

Results: We analyzed 22 pregnancies in 18 women (26-39 years old) 78 ± 37 months after transplantation. Serum creatinine before conception was 92 ± 26 μmol/L; 3 years after delivery, it was 117 ± 67 μmol/L. There were no rejections during pregnancy. Three rejections occurred in the first 9 months after delivery. The median duration of pregnancies was 37 weeks. Preeclampsia occurred in 4 women and severe eclampsia occurred in 2 women. In 19 cases, delivery was by caesarean section. One child was born with trisomy of chromosome 21 and 3 children were born with minor congenital anomalies.

Conclusions: Renal function and proteinuria did not deteriorate 3 years after pregnancy, even after 2 pregnancies. Rejections in the early post-pregnancy period were common. Preeclampsia was more frequent than in the average population. The incidence of major congenital anomalies was comparable to that seen in pregnant women without immunosuppression.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Creatinine / blood
  • Delivery, Obstetric / statistics & numerical data*
  • Female
  • Humans
  • Immunosuppression Therapy / adverse effects
  • Kidney / physiopathology
  • Kidney Transplantation / adverse effects*
  • Postoperative Period
  • Pregnancy
  • Pregnancy Complications / epidemiology*
  • Pregnancy Complications / etiology
  • Pregnancy Complications / physiopathology
  • Pregnancy Outcome / epidemiology*
  • Retrospective Studies
  • Risk Factors
  • Slovenia / epidemiology
  • Transplants / physiopathology

Substances

  • Creatinine