Department of Medicine, Jinnah Sindh Medical University, Karachi, Pakistan.
Department of Biochemistry, Jinnah Sindh Medical University, Karachi, Pakistan.
Womens Health (Lond). 2024 Jan-Dec;20:17455057241277520. doi: 10.1177/17455057241277520.
Kidney transplantation is a superior treatment for end-stage renal disease (ESRD), compared with hemodialysis, offering better quality of life and birth outcomes in women with ESRD and lower fertility rates.
To investigate the pregnancy, maternal, fetal, and graft outcomes following kidney transplantation in women with ESRD and evaluate the improvements in quality of life and associated risks.
A systematic review and meta-analysis performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Meta-analysis of Observational Studies in Epidemiology guidelines.
A thorough search of multiple databases, including PubMed, Embase, Scopus, ATC abstracts, and Cochrane Central Register of Controlled Trials, was conducted to identify studies that analyzed pregnancy outcomes in kidney transplant patients. The search was conducted from the inception of each database to January 2023.
The study reviewed 109 studies that evaluated 7708 pregnancies in 5107 women who had undergone renal transplantation. Of these, 78.48% resulted in live births, 9.68% had induced abortion, and 68.67% had a cesarean section. Miscarriage occurred in 12.54%, preeclampsia in 20.87%, pregnancy-induced hypertension in 24.30%, gestational diabetes in 5.08%, and preterm delivery in 45.30% of cases. Of the 853 recipients, 123 had graft loss after pregnancy and 8.06% suffered acute rejection.
Pregnancy after kidney transplantation is associated with risks for mother and fetus; however, live births are still possible. In addition, there are reduced overall risks of stillbirths, miscarriages, neonatal deaths, and gestational diabetes.
PROSPERO (CRD42024541659).
与血液透析相比，肾移植是治疗终末期肾病（ESRD）的一种更好的方法，它能提高 ESRD 女性的生活质量和生育结局，并降低生育能力。
研究 ESRD 女性肾移植后的妊娠、母婴、胎儿和移植物结局，并评估生活质量的改善及其相关风险。
根据系统评价和荟萃分析的首选报告项目以及观察性研究荟萃分析的流行病学指南进行的系统评价和荟萃分析。
对多个数据库（包括 PubMed、Embase、Scopus、ATC 摘要和 Cochrane 对照试验中心注册）进行全面检索，以确定分析肾移植患者妊娠结局的研究。检索从每个数据库的创建开始，一直持续到 2023 年 1 月。
该研究回顾了 109 项研究，这些研究评估了 5107 名接受过肾移植的女性的 7708 次妊娠。其中，78.48%为活产，9.68%为人工流产，68.67%为剖宫产。流产率为 12.54%，子痫前期为 20.87%，妊娠高血压为 24.30%，妊娠期糖尿病为 5.08%，早产率为 45.30%。在 853 名受者中，有 123 名在妊娠后发生移植物丢失，8.06%发生急性排斥反应。
肾移植后妊娠对母婴都有风险，但仍有可能活产。此外，死产、流产、新生儿死亡和妊娠期糖尿病的总体风险降低。
PROSPERO（CRD42024541659）。
