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Risk of adverse maternal and fetal outcomes during pregnancy in living kidney donors: A matched cohort study
Author(s) -
Davis Scott,
Dylewski James,
Shah Pratik B.,
Holmen John,
You Zhiying,
Chonchol Michel,
Kendrick Jessica
Publication year - 2019
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.13453
Subject(s) - medicine , pregnancy , preeclampsia , obstetrics , odds ratio , kidney disease , gestational diabetes , gestational hypertension , eclampsia , diabetes mellitus , small for gestational age , gestation , endocrinology , genetics , biology
Background We examined the risk of adverse pregnancy outcomes in primiparous kidney donors compared to matched controls. Methods Fifty‐nine women with a history of kidney donation prior to their first pregnancy with normal renal function and no history of kidney disease, diabetes or chronic hypertension were matched 1:4 by age (within 2 years) and race to women with two kidneys using data from an integrated healthcare delivery system. Adverse pregnancy outcomes were defined as preterm delivery (delivery <37 weeks), delivery via cesarean section, gestational hypertension, preeclampsia/eclampsia, gestational diabetes, length of stay in the hospital >3 days, infant death/transfer to acute facility and low birthweight (<2500 g). Results Living kidney donors did not have a higher risk of adverse outcomes compared to matched controls. There was a trend toward an increased risk of preeclampsia/eclampsia in kidney donors but it did not reach statistical significance (Odds ratio [OR]: 2.96, 95% CI: 0.98‐8.94, P = 0.06). However, in kidney donors ≤30 years of age, there was a fourfold increased risk of preeclampsia/eclampsia (OR: 4.09, 95% CI: 1.07‐15.59, P = 0.04). Conclusion Overall, the risk of pregnancy‐associated complications following kidney donation is small but potential female kidney donors should be counseled on the possible increased risk of preeclampsia.