Pregnancy in Irish renal transplant recipients in the cyclosporine era

Background The effect of renal transplantation on pregnancy in Irish women nor receiving CyA has been reported previously. Aim To examine all pregnancies occurring in Irish female renal transplant recipients since the introduction of CyA. Methods Using a community based approach, we identified 29 pregnancies in 19 women, aged between 16 and 45, mean age 30.3 years. Results These pregnancies ended in four miscarriages (13%), two intra-uterine deaths (6.9%) and 23 live births (79.3%). Of these live births, 73.9% were premature (less than or equal to 36 weeks) and 65.2% were of low birth weight (<2500g), Admission to the neonatal intensive care was necessary in 61%, and two babies (8.7%) died in the neonatal period. Mean gestational age was 34 weeks, and mean birth weight was 2190g. There was no change in graft function during pregnancy, with a small rise in serum creatinine post-partum (+9.64 mu mol/L). The renal graft failed in three women (15.8%) by the end of the follow-up period. Compared with the precyclosporine era, the live birth rate was higher (79.3% versus 58%) with a trend towards lower birth weight and shorter gestation. Conclusion Renal transplantation with CyA use is not a contraindication to pregnancy, but it is associated with increased risk, especially when the serum creatinine is >175 mu mol/L.