Evidence map›Paper›PMID 41001606›Full record

ArticleO&G open2024

Unintended Pregnancy After Kidney Transplantation: Risk Factors and Associated Obstetric and Allograft Outcomes.

Ophelia Yin, Catherine Gliwa, Anjali Walia, Lisa Coscia, Serban Constantinescu, Michael Moritz, Monika Sarkar, Roxanna Irani, Yalda Afshar

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in O&G open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Ophelia YinDivision of Maternal Fetal Medicine and Reproductive Genetics, Department of Obstetrics, Gynecology, and Reproductive Sciences, and the Division of Transplant Hepatology, Department of Medicine, University of California, San Francisco, and the University of California San Francisco School of Medicine, San Francisco, and the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, David Geffen School of Medicine, and the Molecular Biology Institute, University of California, Los Angeles, Los Angeles, California; the Section of Complex Family Planning, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan; and the Transplant Pregnancy Registry International, Gift of Life Institute, and the Section of Nephrology, Hypertension, and Kidney Transplantation, Department of Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania.
Catherine GliwaDivision of Maternal Fetal Medicine and Reproductive Genetics, Department of Obstetrics, Gynecology, and Reproductive Sciences, and the Division of Transplant Hepatology, Department of Medicine, University of California, San Francisco, and the University of California San Francisco School of Medicine, San Francisco, and the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, David Geffen School of Medicine, and the Molecular Biology Institute, University of California, Los Angeles, Los Angeles, California; the Section of Complex Family Planning, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan; and the Transplant Pregnancy Registry International, Gift of Life Institute, and the Section of Nephrology, Hypertension, and Kidney Transplantation, Department of Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania.
Anjali WaliaDivision of Maternal Fetal Medicine and Reproductive Genetics, Department of Obstetrics, Gynecology, and Reproductive Sciences, and the Division of Transplant Hepatology, Department of Medicine, University of California, San Francisco, and the University of California San Francisco School of Medicine, San Francisco, and the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, David Geffen School of Medicine, and the Molecular Biology Institute, University of California, Los Angeles, Los Angeles, California; the Section of Complex Family Planning, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan; and the Transplant Pregnancy Registry International, Gift of Life Institute, and the Section of Nephrology, Hypertension, and Kidney Transplantation, Department of Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania.
Lisa CosciaDivision of Maternal Fetal Medicine and Reproductive Genetics, Department of Obstetrics, Gynecology, and Reproductive Sciences, and the Division of Transplant Hepatology, Department of Medicine, University of California, San Francisco, and the University of California San Francisco School of Medicine, San Francisco, and the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, David Geffen School of Medicine, and the Molecular Biology Institute, University of California, Los Angeles, Los Angeles, California; the Section of Complex Family Planning, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan; and the Transplant Pregnancy Registry International, Gift of Life Institute, and the Section of Nephrology, Hypertension, and Kidney Transplantation, Department of Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania.
Serban ConstantinescuDivision of Maternal Fetal Medicine and Reproductive Genetics, Department of Obstetrics, Gynecology, and Reproductive Sciences, and the Division of Transplant Hepatology, Department of Medicine, University of California, San Francisco, and the University of California San Francisco School of Medicine, San Francisco, and the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, David Geffen School of Medicine, and the Molecular Biology Institute, University of California, Los Angeles, Los Angeles, California; the Section of Complex Family Planning, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan; and the Transplant Pregnancy Registry International, Gift of Life Institute, and the Section of Nephrology, Hypertension, and Kidney Transplantation, Department of Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania.
Michael MoritzDivision of Maternal Fetal Medicine and Reproductive Genetics, Department of Obstetrics, Gynecology, and Reproductive Sciences, and the Division of Transplant Hepatology, Department of Medicine, University of California, San Francisco, and the University of California San Francisco School of Medicine, San Francisco, and the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, David Geffen School of Medicine, and the Molecular Biology Institute, University of California, Los Angeles, Los Angeles, California; the Section of Complex Family Planning, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan; and the Transplant Pregnancy Registry International, Gift of Life Institute, and the Section of Nephrology, Hypertension, and Kidney Transplantation, Department of Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania.
Monika SarkarDivision of Maternal Fetal Medicine and Reproductive Genetics, Department of Obstetrics, Gynecology, and Reproductive Sciences, and the Division of Transplant Hepatology, Department of Medicine, University of California, San Francisco, and the University of California San Francisco School of Medicine, San Francisco, and the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, David Geffen School of Medicine, and the Molecular Biology Institute, University of California, Los Angeles, Los Angeles, California; the Section of Complex Family Planning, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan; and the Transplant Pregnancy Registry International, Gift of Life Institute, and the Section of Nephrology, Hypertension, and Kidney Transplantation, Department of Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania.
Roxanna IraniDivision of Maternal Fetal Medicine and Reproductive Genetics, Department of Obstetrics, Gynecology, and Reproductive Sciences, and the Division of Transplant Hepatology, Department of Medicine, University of California, San Francisco, and the University of California San Francisco School of Medicine, San Francisco, and the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, David Geffen School of Medicine, and the Molecular Biology Institute, University of California, Los Angeles, Los Angeles, California; the Section of Complex Family Planning, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan; and the Transplant Pregnancy Registry International, Gift of Life Institute, and the Section of Nephrology, Hypertension, and Kidney Transplantation, Department of Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania.
Yalda AfsharDivision of Maternal Fetal Medicine and Reproductive Genetics, Department of Obstetrics, Gynecology, and Reproductive Sciences, and the Division of Transplant Hepatology, Department of Medicine, University of California, San Francisco, and the University of California San Francisco School of Medicine, San Francisco, and the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, David Geffen School of Medicine, and the Molecular Biology Institute, University of California, Los Angeles, Los Angeles, California; the Section of Complex Family Planning, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan; and the Transplant Pregnancy Registry International, Gift of Life Institute, and the Section of Nephrology, Hypertension, and Kidney Transplantation, Department of Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo define risk factors, obstetric morbidity, and allograft outcomes associated with an unintended pregnancy after kidney transplant.

methodsThis is a retrospective cohort study of pregnancies in women after kidney transplantation enrolled in the Transplant Pregnancy Registry International with births between 1967 and 2019, with cohorts categorized as intended pregnancies and unintended pregnancies. The primary outcome was acute kidney rejection during pregnancy or by 6 weeks postpartum. Secondary outcomes included allograft loss, severe maternal morbidity, and neonatal composite morbidity. Multivariable logistic regression, Kaplan-Meier curves, and Cox proportional hazards regression models were performed, with adjustment for covariates pertinent to allograft function.

resultsAmong 1,723 pregnancies of kidney transplant recipients, 1,081 (62.7%) were intended and 642 (37.3%) were unintended pregnancies. Risk factors for unintended pregnancy included younger age, Black race, nulliparity, chronic hypertension, and transplant from a deceased donor. Exposure to mycophenolate products (16.0% vs 5.7%) and termination (4.7% vs 0.4%) were more common in unintended pregnancies (

conclusionUnintended pregnancy was not associated with acute kidney allograft rejection in the peripartum period, but it was associated with mycophenolate exposure and allograft loss at 2 years from pregnancy. The same social vulnerabilities that underlie difficulty in accessing reproductive care may be similarly important for transplant health. We recommend prepregnancy counseling and longitudinal follow-up of transplant recipients to reduce rates of unintended pregnancy and to optimize transplantation success over time.

Identifiers

PMID41001606
PMCPMC12456589

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.