Introduction
Patients and methods
Study design and population
Statistics
Results
Maternal characteristics
Patients | n = 28(%)* |
---|---|
Age at transplantation (years) | 26.4 ± 5.6 |
Age at delivery (years) | 32.0 ± 4.3 |
Number of kidney transplantations | |
1st kidney transplant | 23(82.2) |
2nd kidney transplant | 2(7.1) |
3rd kidney transplant | 1(3.6) |
Kidney-pancreas transplant | 2(7.1) |
Living kidney donor | 12(46.1) |
Deceased donor | 16(53.9) |
Cause of end-stage renal disease | |
Glomerulonephritis | 11(39.3) |
Diabetes type I | 2(7.1) |
Hemolytic uremic syndrome | 2(7.1) |
Obstructive nephropathy | 2(7.1) |
Interstitial nephritis | 2(7.1) |
Nephronophthisis | 2(7.1) |
Vesicourethral reflux | 2(7.1) |
Unknown | 5(17.9) |
Interval from transplantation to conception** | |
< 2 years | 2(6.1%) |
2–5 years | 9(27.2%) |
≥ 5 years | 21(65.6%) |
Pre-pregnancy hypertension | 19(67.8) |
Number of antihypertensive agents pre-pregnancy, median | 2 |
Time interval (years) Transplantation-conception | > 2–5 years (n = 9) (%) | > 5 years (n = 21) (%) | P value |
---|---|---|---|
Median maternal age at delivery (years, IQR) | 32.8(29.5, 33.5) | 32.9(29.0, 36.0) | 0.533 |
Preeclampsia | 0 | 5(23.8%) | 0.021 |
Caesarean section | 5(55.5%) | 18(85.7%) | 0.075 |
Preterm birth | 5(55.5%) | 17(80.9%) | 0.078 |
Gestational age (weeks), Median (IQR) | 36.29 (34.7, 37.5) | 34.3 (29.6, 36.1) | 0.030 |
Birth weight (g) Median (IQR) | 2.280(1.940, 2715) | 1.885(985, 2290) | 0.058 |
Low birth weight | 5(55.5%) | 17(80.9%) | 0.078 |
Duration of gestations and delivery mode
Patients | n = 28 |
---|---|
Number of pregnancies | 32 |
Median gestational age (weeks), IQR | 34.7(31.9, 36.3) |
Delivery | |
Vaginal birth | 8(25%) |
Caesarean section without labor* | 22(68.8%) |
Caesarean section with labor | 2(6.2%) |
Preeclampsia | 5(15.6%) |
Gestational diabetes | 2(6.2%) |
Indication for caesarean section | |
Maternal | 16(66.7%) |
Fetal | 5(20.8%) |
Combined (maternal and fetal) | 3(12.5%) |
Renal outcome | |
Pre-pregnancy GFR (CKD-EPI) (ml/min/1,73m2), median (IQR) | 57(52, 78) |
GFR (CKD-EPI) at delivery | 49(37, 59)a |
GFR (CKD-EPI) 12 months after delivery | 50(39, 69)b |
GFR (CKD-EPI) 24 months after delivery | 47(41, 80) |
Graft failure within 24 months after delivery | 2(6.2%) |
Proteinuria | |
Proteinuria at delivery, mg/g creatinine, median (range) | 335(100–4000) |
Live births | n = 32(%) | P value |
---|---|---|
Median gestational age (weeks), (IQR) | 34.7(31.9, 36.3) | |
Live births (gestational age, weeks) | ||
Extremely premature birth (< 28 weeks) | 4(12.5) | |
Very premature birth (28–32 weeks) | 4(12.5) | |
Moderate- to late premature birth (32–37 weeks) | 17(53.1) | |
Term > 37 | 7(21.8) | |
Median birth weight (grams, IQR) | 2030 (1380, 2375) | |
SGA | 13(40.6) | |
AGA | 19(59.6) | |
Birth weight (grams) | ||
3000–3500 g | 2(6.1) | |
2500–3000 g | 5(15.6) | |
< 2500 g, low birth weight* | 25(75.7) | |
Median birth weight (grams, IQR) | 0.002 | |
Preterm | 1810(1105, 2240) | |
Term | 2550(2225, 2915) | |
Median Birth length (cm, IQR) | 0.006 | |
Preterm | 43.0(37.0, 46.0) | |
Term | 48.0(46.0, 50.0) | |
Head circumference (cm, IQR) | 0.011 | |
Preterm | 31.0(27, 32.5) | |
Term | 33.0(32.0, 34.0) | |
pH at delivery (livebirths) | ||
< 7.0 | 0 | |
> 7.0- ≤ 7.1 | 1(3.1) | |
> 7.1- ≤ 7.2 | 8(25) | |
> 7.2 | 23(71.8) | |
APGAR | ||
≤ 4 after 1 min | 5(15) | |
< 7 after 5 min | 7(21.2) |
Maternal complications in gestation
Graft outcome
Fetal outcome and development
Childrens development from birth through age of 2 years
Parameter | Preterm | Term | P value |
---|---|---|---|
Birth (median, IQR), | |||
Weight, g | 1.810(1105, 2240) | 2.550(2225, 2915) | 0.002 |
Length,cm | 43.0(37.0, 46.0) | 48.0(46.0, 50.0) | 0.006 |
Head circumference, cm | 31.0(27, 32.5) | 33(32.0, 34.0) | 0.011 |
12 months (median, IQR), | |||
weight, g | 8760(7670, 9570) | 9180(9090, 9992) | 0.704 |
length, cm | 74.0(72.0, 75.5) | 74.1(73.3, 76.3) | 0.71 |
Head circumference, cm | 46.0(45.0, 46.7) | 46.0(46.0, 49.0) | 0.365 |
24 months, (median, IQR) | |||
weight, g | 11.800(10.950, 13.250) | 11.900 (11.600, 12.900) | 0.769 |
length, cm | 84.0(83.0, 87.7) | 86.0(84.5, 88.3) | 0.308 |
Head circumference, cm | 48.2 (47.5, 49.5) | 49.5(48.5, 49.7) | 0.410 |
Variables | Z-score |
---|---|
Weight (IQR) | |
Birth | −1.04(−1.43, −0.54) |
12 months | −0.375(−0.82, 0.1) |
24 months | −0.31(−0.94, 0.32) |
Length (IQR) | |
Birth | −.79(− 1.43, − 0.15) |
12 months | − 0.07(− 0.69, 0.28) |
24 months | −0.78(− 1.15, − 0.17) |
Head circumference (IQR) | |
Birth | −.65 (− 1.4, 0.0075) |
12 months | − 0.28(− 0.74, 0.51) |
24 months | −0.05(− 1.1, 0.36) |