2008 JASN IMPACT FACTOR 7.505	HOME   AUTHOR INFO   EDITORIAL BOARD   SUBSCRIBE   FEEDBACK   ALERTS   HELP
advanced	CURRENT ISSUE	ARCHIVES	JASN Express	ONLINE SUBMISSION

This Article Full Text Full Text (PDF) Press Release All Versions of this Article: ASN.2008121241v1 20/11/2433    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Levidiotis, V. Articles by McDonald, S. PubMed PubMed Citation Articles by Levidiotis, V. Articles by McDonald, S.

Pregnancy and Maternal Outcomes Among Kidney Transplant Recipients

Vicki Levidiotis^*,,, Sean Chang^* and Stephen McDonald^*,,||

*Australian and New Zealand Dialysis and Transplant (ANZDATA) Registry, Adelaide, South Australia, Australia;
Department of Renal Medicine, Royal Prince Alfred Hospital, Camperdown New South Wales, Australia;
Department of Medicine, University of Sydney, New South Wales, Australia;
Department of Medicine, University of Adelaide, South Australia, Australia; and
^||Renal Unit, Queen Elizabeth Hospital, Adelaide, South Australia, Australia

Correspondence: Dr. Vicki Levidiotis, Western Hospital, Gordon Street Footscray, Victoria 3011, Australia. Phone: 03-8345-6666; Fax: 03-8345-7019; E-Mail: vicki.levidiotis{at}wh.org.au

Received for publication December 7, 2008. Accepted for publication July 3, 2009.

Fertility rates, pregnancy, and maternal outcomes are not well described among women with a functioning kidney transplant. Using data from the Australian and New Zealand Dialysis and Transplant Registry, we analyzed 40 yr of pregnancy-related outcomes for transplant recipients. This analysis included 444 live births reported from 577 pregnancies; the absolute but not relative fertility rate fell during these four decades. Of pregnancies achieved, 97% were beyond the first year after transplantation. The mean age at the time of pregnancy was 29 ± 5 yr. Compared with previous decades, the mean age during the last decade increased significantly to 32 yr (P < 0.001). The proportion of live births doubled during the last decade, whereas surgical terminations declined (P < 0.001). The fertility rate (or live-birth rate) for this cohort of women was 0.19 (95% confidence interval 0.17 to 0.21) relative to the Australian background population. We also matched 120 parous with 120 nulliparous women by year of transplantation, duration of transplant, age at transplantation ±5 yr, and predelivery creatinine for parous women or serum creatinine for nulliparous women; a first live birth was not associated with a poorer 20-yr graft or patient survival. Maternal complications included preeclampsia in 27% and gestational diabetes in 1%. Taken together, these data confirm that a live birth in women with a functioning graft does not have an adverse impact on graft and patient survival.

Copyright © 2009 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673