Obstetrical and neonatal outcomes in renal transplant recipients.

OBJECTIVE

To measure the incidence and outcomes of pregnancies in renal transplant (RT) patients and to identify risk factors of adverse pregnancy outcomes.

METHODS

We conducted a population-based retrospective cohort study using the United States Nationwide Inpatient Sample from 2003-2010. The incidence of pregnancies in women with RT was measured and logistic regression analysis was used to estimate the adjusted effect of RT on maternal and fetal outcomes.

RESULTS

We identified 375 deliveries in patients with a RT among 7094300 births for an overall incidence of 5.3 cases per 100000 births over 8 years. Maternal complications, including preeclampsia OR=9.87 (7.76, 12.55) and blood transfusion OR=2.29 (1.69, 3.12) were more common in women with RT as compared to in women without. RT pregnancies were also complicated by an increased risk of preterm birth OR=4.65 (3.72, 5.81), intrauterine fetal death OR=3.67 (1.89, 7.15) and fetal congenital anomalies OR=5.28 (2.81, 9.90). Among women with RT and pre-existing hypertension, the risk of intrauterine growth restriction (IUGR) was considerably increased from 4.3% to 21.8%, OR=3.79 (1.67, 8.62).

CONCLUSION

Pregnancies in RT patients are associated with an increased risk of maternal and fetal morbidities. Among women with RT, pre-existing hypertension strongly increases the risk of IUGR.