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BMC Nephrology
Published in: BMC Nephrology 1/2019

Open Access 01-12-2019 | Gestational Diabetes | Research article

Pregnancy outcomes in women with kidney transplant: Metaanalysis and systematic review

Authors: Silvi Shah, Renganathan Lalgudi Venkatesan, Ayank Gupta, Maitrik K. Sanghavi, Jeffrey Welge, Richard Johansen, Emily B. Kean, Taranpreet Kaur, Anu Gupta, Tiffany J. Grant, Prasoon Verma

Published in: BMC Nephrology | Issue 1/2019

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Abstract

Background

Reproductive function in women with end stage renal disease generally improves after kidney transplant. However, pregnancy remains challenging due to the risk of adverse clinical outcomes.

Methods

We searched PubMed/MEDLINE, Elsevier EMBASE, Scopus, BIOSIS Previews, ISI Science Citation Index Expanded, and the Cochrane Central Register of Controlled Trials from date of inception through August 2017 for studies reporting pregnancy with kidney transplant.

Results

Of 1343 unique studies, 87 met inclusion criteria, representing 6712 pregnancies in 4174 kidney transplant recipients. Mean maternal age was 29.6 ± 2.4 years. The live-birth rate was 72.9% (95% CI, 70.0–75.6). The rate of other pregnancy outcomes was as follows: induced abortions (12.4%; 95% CI, 10.4–14.7), miscarriages (15.4%; 95% CI, 13.8–17.2), stillbirths (5.1%; 95% CI, 4.0–6.5), ectopic pregnancies (2.4%; 95% CI, 1.5–3.7), preeclampsia (21.5%; 95% CI, 18.5–24.9), gestational diabetes (5.7%; 95% CI, 3.7–8.9), pregnancy induced hypertension (24.1%; 95% CI, 18.1–31.5), cesarean section (62.6, 95% CI 57.6–67.3), and preterm delivery was 43.1% (95% CI, 38.7–47.6). Mean gestational age was 34.9 weeks, and mean birth weight was 2470 g. The 2–3-year interval following kidney transplant had higher neonatal mortality, and lower rates of live births as compared to > 3 year, and < 2-year interval. The rate of spontaneous abortion was higher in women with mean maternal age < 25 years and > 35 years as compared to women aged 25–34 years.

Conclusion

Although the outcome of live births is favorable, the risks of maternal and fetal complications are high in kidney transplant recipients and should be considered in patient counseling and clinical decision making.
Appendix
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Metadata
Title
Pregnancy outcomes in women with kidney transplant: Metaanalysis and systematic review
Authors
Silvi Shah
Renganathan Lalgudi Venkatesan
Ayank Gupta
Maitrik K. Sanghavi
Jeffrey Welge
Richard Johansen
Emily B. Kean
Taranpreet Kaur
Anu Gupta
Tiffany J. Grant
Prasoon Verma
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Nephrology / Issue 1/2019
Electronic ISSN: 1471-2369
DOI
https://doi.org/10.1186/s12882-019-1213-5

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