ABSTRACT
OBJECTIVE: To evaluate risk factors affecting pregnancy, perinatal outcomes and graft condition in women who underwent renal transplantation. METHODS: Retrospective study of 34 pregnancies in 28 renal recipients followed in a single tertiary center from January 1989 to January 2007. MAIN OUTCOME MEASURES: Pregnancy outcome, kidney allograft function, maternal complications and perinatal outcomes were evaluated in these patients. RESULTS: Mean maternal age at time of pregnancy was 27+/-5.1 years (18-37) and the interval between transplant and pregnancy varied between 1 and 134 months (mean 51.3+/-34.2). Most pregnant women (25/28) were submitted to triple immunosuppression during the entire pregnancy. The fetal outcome included 27 live births (79.4%), 2 stillbirths (5.9%), 3 spontaneous abortions (8.8%) and 2 therapeutic abortions (5.9%). The most frequent maternal complications were hypertension in 18 pregnancies, 2 of which ended in pre-eclampsia; urinary tract infections in 10 pregnancies; gestational diabetes mellitus in 3, anemia in 3 and 2 acute graft rejections. The major fetal complications observed consisted of four (13. 8%) intrauterine growth restrictions and two (6.9%) stillbirths. Vaginal delivery occurred in 10 women (34.5%); in the other 19 (65.5%), a cesarean section was performed. Of the 27 successful pregnancies, 11 (40.7%) resulted in term deliveries and 16 (59.3%) in preterm deliveries (range 31-39 weeks). The mean birth weight of the offspring was 2,465 g (range 1,300-3,530). There were no major perinatal complications, but two allograft rejections occurred after pregnancy. CONCLUSIONS: This series results are in agreement with those in other studies. Even though pregnancy does not seem to adversely affect short-term renal allograft function, risks of obstetric and perinatal complications seem to be increased. Further studies of long term graft function and pediatric follow-up are needed.
