Pregnancy Outcomes Using Assisted Reproductive Technology in Kidney Transplant Recipients.
Publication/Presentation Date
7-4-2025
Abstract
BACKGROUND: Infertility is common among those with kidney transplants, and pregnancy is associated with a high risk of adverse maternal and fetal outcomes. Little is known about the outcomes of pregnancy with assisted reproductive technology (ART) in women with kidney transplants.
METHODS: This retrospective cohort study used data from the Transplant Pregnancy Registry International. Eligible participants were recipients of a kidney transplant between March 1968 and July 2022 who were aged 14 y or older at conception. Logistic regression analyses (adjusted for age at conception and race) were constructed to compare pregnancy outcomes with ART versus natural conception.
RESULTS: There were 130 pregnancies using ART in 77 kidney transplant recipients. ART pregnancies, as compared with natural conception pregnancies, were associated with a higher adjusted likelihood of hypertension during pregnancy (odds ratio [OR], 1.57; 95% confidence interval [CI], 1.06-2.32), higher adjusted likelihood of cesarean delivery (OR, 1.60; 95% CI, 1.02-2.51), and higher adjusted risk of preterm births < 37 wk (OR, 2.07; 95% CI, 1.35-3.18). Pregnancies with ART, as compared with natural conception, had a lower median birth weight (2551 versus 2722.0 g), a lower median gestational age (36.0 versus 37.0 wk), and a higher proportion of neonatal deaths (4.4% versus 0.8%). No differences were observed in the adjusted likelihood of preeclampsia, gestational diabetes, miscarriages, live births, low birth weights, birth defects, or 2-y graft loss between ART and natural conception pregnancies.
CONCLUSIONS: ART pregnancies are associated with a higher risk of preterm births, hypertension during pregnancy, and cesarean delivery compared with naturally conceived pregnancies. The likelihood of live births and 2-y graft loss did not differ.
ISSN
1534-6080
Published In/Presented At
Shah, S., Rachwal, B., Vyas, P., Basera, P., Rao, S., Sheshashayee, N., Leonard, A. C., Verma, P., Konel, J., Constantinescu, S., Moritz, M., Jesudason, S., & Coscia, L. A. (2025). Pregnancy Outcomes Using Assisted Reproductive Technology in Kidney Transplant Recipients. Transplantation, 10.1097/TP.0000000000005449. Advance online publication. https://doi.org/10.1097/TP.0000000000005449
Disciplines
Medicine and Health Sciences
PubMedID
40611379
Department(s)
Department of Surgery
Document Type
Article
