Pregnancy outcome after renal allograft transplantation: 15 years experience

Ghanem, M.; El-Baghdadi, L.A.; Badawy, Ahmed; Bakr, Mohamed A.; Sobhe, M.A.; Ghoneim, Mohamed A.

doi:10.1016/j.ejogrb.2004.11.035

Cited by 45 publications

(35 citation statements)

References 11 publications

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“…Other series have also reported favorable outcomes in patients with preconception creatinines of Ͻ1.5 mg/dl. Predictors of preterm delivery published to date include maternal hypertension (Ն140/90; OR 6.3 36 ), 1 proteinuria (Ն0.3 g/d; OR 11.7 36 ), 5 and serum creatinine (Ն1.5 mg/ dl), 1,36 before pregnancy. Traditionally, these predictors of risk have been used to advise women about the likely outcome of their pregnancy.…”

Section: Discussionmentioning

confidence: 99%

“…14 In most instances, pregnancies in women with a kidney graft have been encouraged. Historically, renal function, 8,15,17,18 baseline proteinuria, 23 inter-current hypertension, 1,24 and time from transplantation 1,3,5,8,14,15,18,24,25 have been used to predict adverse event risks to the mother, kidney, and offspring. To this are added the often unquantifiable inherent risks for genetically transmitted diseases or the problems associated with prematurity.…”

mentioning

confidence: 99%

“…Prenatal advice for women with a functioning kidney transplant has been primarily based on data derived from observational research, [1][2][3][4][5][6][7][8][9][10][11][12][13] and the reported live-birth rates achieved in such women range from 43.2 14 to 82%. 15 Although an increased pregnancy event number has been reported for women with a functioning kidney transplant, 16 little is actually known about "pregnancy rate changes" during the past 40 yr. More importantly, long-term graft and maternal survival analyses, referred to when advising women who have undergone transplantation and are considering a pregnancy, have been mostly performed without adequate matching, 12 or, alternatively, matching has been used but outcomes followed up for only brief intervals 14,17,18 and in small cohorts.…”

mentioning

confidence: 99%

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Pregnancy and Maternal Outcomes Among Kidney Transplant Recipients

Levidiotis

Chang²,

McDonald

2009

Journal of the American Society of Nephrology

131

100

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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 Ϯ 5 yr. Compared with previous decades, the mean age during the last decade increased significantly to 32 yr (P Ͻ 0.001). The proportion of live births doubled during the last decade, whereas surgical terminations declined (P Ͻ 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 Ϯ5 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.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Pregnancy and Maternal Outcomes Among Kidney Transplant Recipients

Levidiotis

Chang²,

McDonald

2009

Journal of the American Society of Nephrology

131

100

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“…Although graft dysfunction and obstructive uropathy are reported in pregnant patients with kidney transplantation (9), studies compared the long -term outcomes of pregnancy on transplanted kidney with nulliparous transplanted controls did not show significant differences in the function or survival of graft in long term (10)(11)(12)(13)(14)(15)(16)(17) (Table 1). Graft function in the 10 -year period was similar between patients with pregnancy history and controls (12)(13)(14)(15).…”

Section: The Effect Of Pregnancy On Transplanted Kidneymentioning

confidence: 99%

“…According to the reported data, it is safe to get the conception 1 year after kidney transplantation (6)(7)(8). Since the function of allograft kidney, time between kidney transplantation and pregnancy, prescribed immunosuppression medication, and comorbid disease make such pregnancies risky (9), preconception counseling is needed to provide safety concerns for the mother, the infant, and the transplanted kidney.…”

Section: Introductionmentioning

confidence: 99%

Currently Available Urine-Based Tumour Markers in the Detection of New and Recurrent Urothelial Bladder Cancer

Horstmann¹

2011

Nephro Urol Mon

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Context: The current study aimed at providing an evidence -based and up-to-date review of the literature regarding the assessment and outcomes of pregnancy in patients with renal transplant. Design: It was a review of the current literature. Conclusions: According to the current study findings, the function or survival of renal allograft was not adversely affected by getting pregnant. Therefore, ideal care for these patients needs a multidisciplinary approach including maternal-fetal medicine, nephrology, and neonatology specialists.

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