SynthesisInternational urology and nephrology2025
Long-term impact of pregnancy on mortality and graft outcomes in kidney transplant recipients: a systematic review and meta-analysis.
Synthesis in International urology and nephrology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Pregnancy-related maternal and fetal outcomes following renal transplantation: a decade of experience at a tertiary care center in Saudi Arabia.BMC pregnancy and childbirth · 2025Article
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimPregnancy in kidney transplant recipients involves complex physiological changes that could potentially impact long-term graft function and survival. Despite some evidence suggesting minimal long-term effects on graft survival, conflicting results on graft function and timing-related risks highlight the need for a comprehensive review. This systematic review and meta-analysis aims to evaluate long-term impact of pregnancy on patient survival, graft failure, serum creatinine levels, estimated glomerular filtration rate (eGFR), and proteinuria in kidney transplant recipients. MATERIALS AND
methodsWe conducted a systematic review and meta-analysis adhering to PRISMA guidelines and registered with PROSPERO (CRD42024569702). We searched PubMed, Scopus, Web of Science, Cochrane Library, and Ovid MEDLINE. Studies were eligible if they provided data on adult kidney transplant recipients (> 18 years) who became pregnant post-transplant and included a control group of non-pregnant or non-conceived individuals.
resultsAmong the 6118 results screened, 19 studies met the eligibility criteria and were included in the meta-analysis. The risk of allograft failure or graft loss was similar between pregnant and non-pregnant controls (OR 1.13, 95% CI 0.83-1.53, p = 0.43), with a slightly higher adverse outcome rate in pregnant patients (25.4 vs. 19.8%). All-cause mortality risk was also comparable (OR 0.63, 95% CI 0.38-1.07, p = 0.09), with low heterogeneity (I
conclusionPregnancy in kidney transplant recipients leads to increased creatinine levels in postpartum but does not significantly affect long-term graft survival. While creatinine levels generally decrease during pregnancy, they show variability by trimester. The risk of allograft failure and mortality is similar between pregnant and non-pregnant recipients though adverse outcomes are slightly more frequent in pregnant patients, emphasizing the need for an optimal follow-up protocol of pregnant transplant recipients that takes trimester-specific graft function variations into consideration and that establishes clear thresholds for further evaluation and timely intervention.
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