Pregnancy and birth: Safe for women with kidney transplants

Women who have had a kidney transplant and have good kidney function can get pregnant and give birth without jeopardizing their health or the health of their transplant. Having children does not affect patients' kidney function or their life-span compared with transplanted women who do not have children, according to a matching cohort study appearing in an upcoming issue of the Journal of the American Society Nephrology (JASN).

There is little information on the health effects of pregnancy and childbirth in women with a functioning kidney transplant. To determine whether getting pregnant and having a baby are safe for these women, Vicki Levidiotis, MD (Royal Prince Alfred Hospital, Australia), and her colleagues analyzed 40 years' worth of pregnancy-related data for transplant recipients in Australia and New Zealand.

The investigators compared 120 women who gave birth after receiving their kidney transplant with 120 transplanted women who did not have children. There were no differences in kidney function or patient survival 20 years after the transplant in these two groups. "In transplanted women who achieve a live birth, and have good kidney function at the time, the birth does not adversely impact on their transplanted kidney or life-span," said Dr. Levidiotis. The authors noted that their findings are good news for kidney transplant women who fear getting pregnant because they fear that their pregnancy may worsen their kidney function or shorten their lifespan and keep them from raising their children.

The birth rate in women who have received a kidney transplant is much lower than in the general population. Dr. Levidiotis and her team found that 444 live births were reported from 577 pregnancies among female kidney transplant recipients in Australia and New Zealand over the past 40 years. The proportion of births doubled during the last decade but the birth rate was approximately 80% lower than that seen in women in the general population, confirming the "relative infertility" of women with kidney transplants. Among women with a functioning kidney transplant who became pregnant, 83% of them went on to give birth.

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The authors report no financial disclosures. Study co-authors include Sean Chang, MBBS, (Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry, Australia), and Stephen McDonald, MBBS, PhD (ANZDATA Registry and Queen Elizabeth Hospital, Australia).

The article, entitled "Pregnancy and Maternal Outcomes Among Kidney Transplant Recipients," will appear online at http://jasn.asnjournals.org/ on September 24, 2009, doi 10.1681/ASN.2008121241.

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