(RxWiki News) Women with kidney disease or kidney failure often face fertility problems. If she is lucky enough to get a kidney transplant, a woman may improve her reproductive health. But is it still safe for her to get pregnant?
For the most part, the answer seems to be "yes."
It is possible to have a successful pregnancy after receiving a kidney transplant. However, pregnancy complications may be higher among women who have received a kidney transplant.
"Carefully monitor your pregnancy if you have had a kidney transplant."
In the United States, an estimated 50,000 women of reproductive age are currently living after getting a kidney transplant. While kidney transplants have been shown to improve reproductive health in women with kidney failure, there is limited information about pregnancy outcomes after kidney transplantation.
"Generally, there are two health issues that make pregnancy very hazardous and at times life-threatening: heart disease and kidney disease," says Catherine Browne, D.O., an obstetrician in Austin, Texas. "I counsel patients with these health issues to strongly consider the statistics before even considering pregnancy. For these women, pregnancy could mean death. Does she really want to risk her health to have a baby?"
With these risks in mind, Dorry Segev, M.D., Ph.D., of Johns Hopkins University, and colleagues examined studies published between 2000 and 2010 that reported pregnancy-related outcomes of women who received kidney transplants.
From their study, the researchers found very high rates of successful pregnancies among kidney transplant recipients. In fact, the live birth rate after kidney transplantation was 73.5 percent, which is higher than the 66.7 percent rate of the general population. Similarly, the miscarriage rate of kidney transplant recipients was more than three percent lower than that of the general population (14 percent versus 17.1 percent).
Despite these encouraging numbers, women who received a kidney transplant were more likely than the general population to have pregnancy-related complications, including high blood pressure, pregnancy-related diabetes, Cesarean section, and premature delivery.
Women have an especially high risk of complications during pregnancy if they became pregnant within two years of having a kidney transplant. In some studies, the complication rate fell by as much as 50 percent when the time between transplant and pregnancy was more than two years.
"This article is encouraging in the sense that the authors find some hope for women with kidney disease who have undergone successful transplant prior to pregnancy (as opposed to getting pregnant while still on dialysis)," says Dr. Browne. "As our transplant technology continues to improve, it is exciting to know that this option offers women who used to be on dialysis the chance to live more full lives as well as the potential for improved pregnancy outcomes."
According to Dr. Segev, these findings provide important information for women of reproductive age who are deciding whether to go through with kidney transplant surgery instead of staying on dialysis.
He adds that the findings also "motivate careful follow-up of pregnant women who are kidney transplant recipients."
This systematic review and meta-analysis is published in the American Journal of Transplantation.