Maternal and infant outcomes of pregnancy after kidney transplantation: a retrospective cohort study

Purpose To investigate the effect of postoperative pregnancy on maternal-infant outcomes and transplanted kidney function in kidney transplantation (KT) recipients. Methods Our study included 104 KT recipients and 104 non-KT women who delivered at four hospitals affiliated with Zhejiang University School of Medicine from December 2015 to November 2023. Results The comparison revealed that most patients recovered normal kidney function within 6 months postpartum. Tacrolimus blood concentration during pregnancy averaged (6.1±1.4) μg/L, increasing to (7.1±2.6) μg/L on the second day after delivery, indicating an upward trend in postpartum concentrations. Compared to the non-KT group, the KT group had higher prevalences of gestational hypertension (33.7% vs. 3.3%), gestational diabetes mellitus (21.2% vs. 17.5%), intrahepatic cholestasis of pregnancy (5.8% vs. 1.7%), placental abruption was (1.9% vs. 0.8%) preterm birth rate (79.8% vs. 9.2%). Conclusion Although pregnancies in KT recipients are considered high-risk, the overall risks are manageable. Strengthening the management of KT recipients with reproductive intent is recommended to improve maternal and infant outcomes.