Original Paper Reproductive Medicine

Irish Journal of Medical Science

, Volume 169, Issue 1, pp 19-21

First online:

Pregnancy in Irish renal transplant recipients in the cyclosporine era

  • M. A. LittleAffiliated withDepartment of Nephrology, Beaumont Hospital
  • , K. A. AbrahamAffiliated withDepartment of Nephrology, Beaumont Hospital
  • , J. KavanaghAffiliated withDepartment of Nephrology, Beaumont Hospital
  • , G. ConnollyAffiliated withDepartment of Obstetrics, Rotunda Hospital
  • , P. ByrneAffiliated withDepartment of Obstetrics, Rotunda Hospital
  • , J. J. WalsheAffiliated withDepartment of Nephrology, Beaumont Hospital

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Abstract

Background

The effect of renal transplantation on pregnancy in Irish women not receiving CyA has been reported previously.

Aim

To examine all pregnancies occurring in Irish female renal transplant recipients since the introduction of CyA.

Methods

Using a community based approach, we identified 29 pregnancies in 19 women, aged between 16 and 45, mean age 30.3 years.

Results

These pregnancies ended in four miscarriages (13%), two intra-uterine deaths (6.9%) and 23 live births (79.3%). Of these live births, 73.9% were premature (≤36 weeks) and 65.2% were of low birth weight (<2500g). Admission to the neonatal intensive care was necessary in 61%, and two babies (8.7%) died in the neonatal period. Mean gestational age was 34 weeks, and mean birth weight was 2190g. There was no change in graft function during pregnancy, with a small rise in serum creatinine post-partum (+9.64μmol/L). The renal graft failed in three women (15.8%) by the end of the follow-up period. Compared with the precyclosporine era, the live birth rate was higher (79.3% versus 58%) with a trend towards lower birth weight and shorter gestation.

Conclusion

Renal transplantation with CyA use is not a contraindication to pregnancy, but it is associated with increased risk, especially when the serum creatinine is >175μmol/L.