Pregnancy outcome after maternal organ transplantation in Sweden

Abstract

Objective: To study pregnancy outcome before and after organ transplantation.

Design: Registry study.

Setting: Swedish Health Registers.

Population: All births in Sweden 1973-2002.

Methods: Women who had organ transplantation were identified from the Hospital Discharge Register and their deliveries before and after the transplantation were identified from the Medical Birth Register. Abortions requiring hospitalisation were identified from the Hospital Discharge Register. Outcomes were compared with those in the total population. Adjustments were made for maternal age, parity and smoking habits.

Main outcome measures: Miscarriage, preterm delivery, low birthweight, small for gestational age, congenital malformations, infant death, pre-eclampsia and placental abruption.

Results: A total of 980 infants born before and 152 born after transplantation were identified. A high frequency of pre-eclampsia (22%), preterm birth (46%), low birthweight (41%), small for gestational age (16%) and infant death (5% before the age of one) were found for deliveries after transplantation but similar frequencies were found also among deliveries a few years before transplantation. No significant increase in congenital malformation rate was seen. Among 15 infants born after liver transplantation, 2 were malformed.

Conclusions: Pregnancies after organ transplantation have an increased risk of complications but this is similar to pregnancies occurring before the transplantation.