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Pregnant kidney transplant recipients face higher risk of adverse outcomes

Pregnant kidney transplant recipients face higher risk of adverse outcomes

Published: 11/7/2018

Pregnancy in kidney transplant recipients is associated with a higher risk of adverse maternal fetal outcomes, according to a study from researchers from the University of Cincinnati (UC). A poster titled "Pregnancy Outcomes in Women with Kidney Transplant: Metaanalysis and Systematic Review” was presented in the transplantation session at the American Society of Nephrology (ASN) meetings in San Diego on Saturday, Oct. 27 by Silvi Shah, MD, assistant professor in the Division of Nephrology, Kidney CARE Program at the UC College of Medicine.

Shah and her team analyzed 87 studies that included 6,712 pregnancies in 4,174 kidney transplant recipients. A quantitative meta-analysis was performed, and the pooled incidence of various maternal and fetal pregnancy outcomes was calculated.  

"Given that pregnancy in kidney transplant recipients can be challenging due to risks associated with immunosuppression and kidney allograft dysfunction, our study focused on pregnancy outcomes in women of childbearing age who are kidney transplant recipients,” says Shah, the lead author of the study.

The study showed the rate of live births was comparable, but the rates of preeclampsia and cesarean  section were significantly higher in the study cohort of kidney transplant recipients than in the general population. The rates of still births and neonatal mortality were also higher in kidney transplant recipients when compared with national data in the general population. 

"Reproductive function in women with end stage renal disease generally improves after kidney transplant,” says Shah. "What our study findings tell us is that pregnancy in kidney transplant recipients is associated with increased risks of adverse maternal and fetal outcomes. We have to consider these associated risks when we counsel women of childbearing age with a history of kidney transplant who are contemplating pregnancy.”

The study was conducted in collaboration with UC’s Health Sciences Library and was supported by the  UC College of Medicine Health Sciences Library Grant.  

"This has been an excellent collaborative effort between researchers from the College of Medicine and Health Sciences Library,” says Tiffany Grant, PhD, assistant director for research and informatics and co-leader of Research Services at the UC College of Medicine Health Sciences Library. "The grant gave us the opportunity to work with an outstanding team of students, data analysts and researchers, and allowed us to show the impact that library and researcher collaborations can have on biomedical research. We look forward to similar collaborations in the future and are grateful for the opportunity provided to us by the College of Medicine Office of Research.” 

The other coauthors of the study include Anu Gupta, MD, from Buffalo Medical Group; Jeffrey Welge, PhD, of the Department of Psychiatry and Behavioral Neuroscience; Taranpreet Kaur, MD, from the Division of Nephrology; Prasoon Verma, MD from Cincinnati Children’s; Renganathan LalgudiVenkatesan, MS; Ayank Gupta, MS; Maitrik Sanghavi, MS; Emily Kean and Tiffany Grant, PhD, from the Health Sciences Library.

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