Pregnancy after kidney transplantation: clinical features, complications and outcomes

Pregnancy after kidney transplantation (KT) has become more common, but the risk of complications and adverse obstetric outcomes in this group of women remains high.Objective: to study pregnancy complications and outcomes in kidney recipients and renal graft (RG) survival after childbirth.Material a...

Full description

Saved in:
Bibliographic Details
Main Authors: E. I. Prokopenko, I. G. Nikolskaya, A. V. Vatazin, F. F. Burumkulova, D. V. Gubina
Format: Article
Language:Russian
Published: Federal Research Center of Transplantology and Artificial Organs named after V.I.Shumakov 2024-07-01
Series:Вестник трансплантологии и искусственных органов
Subjects:
Online Access:https://journal.transpl.ru/vtio/article/view/1739
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849242165748695040
author E. I. Prokopenko
I. G. Nikolskaya
A. V. Vatazin
F. F. Burumkulova
D. V. Gubina
author_facet E. I. Prokopenko
I. G. Nikolskaya
A. V. Vatazin
F. F. Burumkulova
D. V. Gubina
author_sort E. I. Prokopenko
collection DOAJ
description Pregnancy after kidney transplantation (KT) has become more common, but the risk of complications and adverse obstetric outcomes in this group of women remains high.Objective: to study pregnancy complications and outcomes in kidney recipients and renal graft (RG) survival after childbirth.Material and methods. The study included 22 pregnancies in 20 women with RG (transplants performed in 2006–2020). The comparison group consisted of 20 healthy women who had 20 pregnancies. Frequency and nature of pregnancy complications, neonatal health indicators, and pregnancy outcomes were evaluated. Graft survival was compared in the main group and in a group of 102 women after KT who did not have pregnancies.Results. Compared with healthy women, RG recipients had a higher rate of preeclampsia (25% and 0%, p = 0.047), fetal growth restriction (30% and 0%, p = 0.020), gestational diabetes (40% and 5%, p = 0.020), asymptomatic bacteriuria (35% and 5%, p = 0.044), preterm birth (60% and 0%, p < 0.001), and cesarean section (70% and 10%, p < 0.001). Median gestational age and birth weight were significantly lower in women with RG: 36.0 [33.9; 37.4] vs. 38.9 [38.9; 39.6] weeks, p < 0.001, and 2405 [2023; 2958] vs. 3355 [3200; 3690] g, p < 0.001, respectively. The rate of favorable pregnancy outcomes after KT was 81.8%, or 90% when early pregnancy loss is excluded. Two children were found to have genetic diseases passed from the mother. Graft survival did not differ between RG recipients with and without pregnancy, p = 0.272.Conclusions. Pregnancy outcomes in patients with RG are generally favorable, pregnancy and childbirth do not affect graft survival. When planning pregnancy after KT, it is necessary to consider the risk of complications and the possibility of transmitting genetic disorders to offspring.
format Article
id doaj-art-e984097992184d86bd7b071b35ef9ca9
institution Kabale University
issn 1995-1191
language Russian
publishDate 2024-07-01
publisher Federal Research Center of Transplantology and Artificial Organs named after V.I.Shumakov
record_format Article
series Вестник трансплантологии и искусственных органов
spelling doaj-art-e984097992184d86bd7b071b35ef9ca92025-08-20T03:59:53ZrusFederal Research Center of Transplantology and Artificial Organs named after V.I.ShumakovВестник трансплантологии и искусственных органов1995-11912024-07-0126281510.15825/1995-1191-2024-2-8-151255Pregnancy after kidney transplantation: clinical features, complications and outcomesE. I. Prokopenko0I. G. Nikolskaya1A. V. Vatazin2F. F. Burumkulova3D. V. Gubina4Vladimirsky Moscow Regional Research and Clinical Institute; Moscow Regional Research Institute of Obstetrics and GynecologyMoscow Regional Research Institute of Obstetrics and GynecologyVladimirsky Moscow Regional Research and Clinical InstituteMoscow Regional Research Institute of Obstetrics and GynecologyVladimirsky Moscow Regional Research and Clinical InstitutePregnancy after kidney transplantation (KT) has become more common, but the risk of complications and adverse obstetric outcomes in this group of women remains high.Objective: to study pregnancy complications and outcomes in kidney recipients and renal graft (RG) survival after childbirth.Material and methods. The study included 22 pregnancies in 20 women with RG (transplants performed in 2006–2020). The comparison group consisted of 20 healthy women who had 20 pregnancies. Frequency and nature of pregnancy complications, neonatal health indicators, and pregnancy outcomes were evaluated. Graft survival was compared in the main group and in a group of 102 women after KT who did not have pregnancies.Results. Compared with healthy women, RG recipients had a higher rate of preeclampsia (25% and 0%, p = 0.047), fetal growth restriction (30% and 0%, p = 0.020), gestational diabetes (40% and 5%, p = 0.020), asymptomatic bacteriuria (35% and 5%, p = 0.044), preterm birth (60% and 0%, p < 0.001), and cesarean section (70% and 10%, p < 0.001). Median gestational age and birth weight were significantly lower in women with RG: 36.0 [33.9; 37.4] vs. 38.9 [38.9; 39.6] weeks, p < 0.001, and 2405 [2023; 2958] vs. 3355 [3200; 3690] g, p < 0.001, respectively. The rate of favorable pregnancy outcomes after KT was 81.8%, or 90% when early pregnancy loss is excluded. Two children were found to have genetic diseases passed from the mother. Graft survival did not differ between RG recipients with and without pregnancy, p = 0.272.Conclusions. Pregnancy outcomes in patients with RG are generally favorable, pregnancy and childbirth do not affect graft survival. When planning pregnancy after KT, it is necessary to consider the risk of complications and the possibility of transmitting genetic disorders to offspring.https://journal.transpl.ru/vtio/article/view/1739kidney transplantationimmunosuppressionpregnancy, complicationspregnancy outcomesrenal graft survival
spellingShingle E. I. Prokopenko
I. G. Nikolskaya
A. V. Vatazin
F. F. Burumkulova
D. V. Gubina
Pregnancy after kidney transplantation: clinical features, complications and outcomes
Вестник трансплантологии и искусственных органов
kidney transplantation
immunosuppression
pregnancy, complications
pregnancy outcomes
renal graft survival
title Pregnancy after kidney transplantation: clinical features, complications and outcomes
title_full Pregnancy after kidney transplantation: clinical features, complications and outcomes
title_fullStr Pregnancy after kidney transplantation: clinical features, complications and outcomes
title_full_unstemmed Pregnancy after kidney transplantation: clinical features, complications and outcomes
title_short Pregnancy after kidney transplantation: clinical features, complications and outcomes
title_sort pregnancy after kidney transplantation clinical features complications and outcomes
topic kidney transplantation
immunosuppression
pregnancy, complications
pregnancy outcomes
renal graft survival
url https://journal.transpl.ru/vtio/article/view/1739
work_keys_str_mv AT eiprokopenko pregnancyafterkidneytransplantationclinicalfeaturescomplicationsandoutcomes
AT ignikolskaya pregnancyafterkidneytransplantationclinicalfeaturescomplicationsandoutcomes
AT avvatazin pregnancyafterkidneytransplantationclinicalfeaturescomplicationsandoutcomes
AT ffburumkulova pregnancyafterkidneytransplantationclinicalfeaturescomplicationsandoutcomes
AT dvgubina pregnancyafterkidneytransplantationclinicalfeaturescomplicationsandoutcomes