Maternal, fetal, and renal outcomes in pregnant women with chronic kidney disease, with and without kidney transplantation

Objective: To compare maternal and fetal outcomes among kidney transplant recipients with those observed in pregnant women with other kidney diseases, recognizing that although pregnancy represents one of the potential benefits of kidney transplantation, these patients remain at increased risk for adverse maternal and fetal complications compared with the general healthy population. Material and methods: A retrospective cohort study was conducted using clinical and electronic records of pregnant women with chronic kidney disease. Cases were divided into two groups: with and without kidney transplants. The χ2 test was used to compare maternal and fetal outcomes in each group, with a p < 0.05 being considered significant. Results: A total of 525 pregnancies in 513 patients with chronic kidney disease were included, and 17 pregnancies were identified in 16 patients with kidney transplants. Among maternal outcomes, preterm delivery was more frequent in patients with kidney transplants (11 cases, 73.3%) than in patients without kidney transplants (220 cases, 45.9%) (p = 0.036). No differences were observed in the frequency of abortion, cesarean section, and preeclampsia. In fetal outcomes, admission to the neonatal intensive care unit was more frequent in the group with kidney transplants (6 cases, 60.0%) than in the group without kidney transplants (144 cases, 30.6%) (p = 0.016). No differences were observed in the percentage of live births, low birth weight, and neonatal death between patients with and without kidney transplants. Conclusions: Preterm birth and admission to the neonatal intensive care unit were more frequent in kidney transplant recipients.