Kociszewska-Najman B, Pietrzak B, Cyganek A, Szpotanska-Sikorska M, Schreiber-Zamora J, Jabiry-Zieniewicz Z, Wielgos M
Neonatal Ward, The 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland.
Transplant Proc. 2011 Oct;43(8):3048-51. doi: 10.1016/j.transproceed.2011.08.041.
Neonates born to mothers, who underwent organ transplantation require close medical monitoring. It is unknown how chronically diseased mother's organs or immunosuppressive drugs affect fetal growth and development; some immunosuppressants are teratogenic and contraindicated during pregnancy. The aim of this study was to determine the prevalence of prematurity and intrauterine growth restriction in neonates born to women who have undergone renal or liver transplantation.
Our retrospective analysis identified 53 (25 renal and 28 liver) cases of neonates delivered by female graft recipients between January 2005 and December 2009. Hypotrophy was defined as a birth weight<10th percentile for gestational age. We excluded newborns diagnosed with severe hypotrophy (<5th percentile).
Neonates born prematurely were predominate in the renal (16/25, 64%), but less than half of the liver cohort (13/28, 46%). Hypotrophy less than the 10th percentile was noted significantly more often among renal than liver recipients; 36% versus 14% (P<.05). Severe hypotrophy was also observed significantly more often among renal than liver transplant neonates: 28% versus 3.6% (P<.001).
Compared with liver insufficiency, chronic kidney diseases have stronger effects on the fetus, leading to adverse neonatal complications. A greater prevalence of preterm births, as well as hypotrophic newborns, especially less than the 5th percentile, was observed among neonates delivered by mothers after kidney transplantation.
接受器官移植的母亲所生的新生儿需要密切的医学监测。目前尚不清楚患有慢性疾病母亲的器官或免疫抑制药物如何影响胎儿的生长发育；一些免疫抑制剂具有致畸性，在怀孕期间禁用。本研究的目的是确定接受肾移植或肝移植的女性所生新生儿的早产和宫内生长受限的患病率。
我们的回顾性分析确定了2005年1月至2009年12月期间女性移植受者分娩的53例新生儿（25例肾移植和28例肝移植）。低体重被定义为出生体重低于胎龄的第10百分位数。我们排除了诊断为严重低体重（<第5百分位数）的新生儿。
肾移植组早产新生儿占主导（16/25，64%），但肝移植组不到一半（13/28，46%）。肾移植受者中低于第10百分位数的低体重情况明显比肝移植受者更常见；分别为36%和14%（P<.05）。肾移植新生儿中严重低体重的情况也明显比肝移植新生儿更常见：分别为28%和3.6%（P<.001）。
与肝功能不全相比，慢性肾脏疾病对胎儿的影响更大，会导致不良的新生儿并发症。肾移植母亲所生新生儿中早产以及低体重新生儿（尤其是低于第5百分位数）的患病率更高。
