[Pregnancy after kidney transplantation : the Erasme Hospital experience]

Abstract

Kidney transplantation can restore the fertility of women with chronic renal insufficiency, allowing them to bear children. Yet, pregnancy after renal graft is associated with high maternal and fetal morbidity. The purpose of this case-controlled retrospective study was to evaluate maternal and fetal outcomes of pregnancies in renal transplant recipients, and to compare the results to a control population. We studied 18 pregnancies in 14 renal grafted patients, between 1990 and 2003. Each pregnancy was paired for age, number of pregnancies and parity with 2 controls. The analyses concerned the presence of risk factors at the conception, the outcome of the pregnancy and the occurring of maternal-fetal complications. There were significantly more infections (50 % versus 11 %), anaemia (28 % versus 3 %), caesarean sections (72 % versus 14 %), intrauterin growth restriction (39 % versus 3 %), premature babies (44 % versus 8 %) and small weights at birth (50 % versus 8 %) in the transplanted women and a trend to an increased incidence of hypertensive complications. One baby of a transplanted mother died. No deterioration of renal function nor any maternal death occurred. In conclusion, the rates of maternal-fetal complications in pregnancies after kidney transplantation found in our hospital are similar to those of the literature and in comparison with controls, make them high-risk pregnancies. Nevertheless, by respecting certain criteria, the majority have a successful outcome.