Dataset Information

Pregnancy outcomes in women with kidney transplant: Metaanalysis and systematic review.

ABSTRACT:

Background

Reproductive function in women with end stage renal disease generally improves after kidney transplant. However, pregnancy remains challenging due to the risk of adverse clinical outcomes.

Methods

We searched PubMed/MEDLINE, Elsevier EMBASE, Scopus, BIOSIS Previews, ISI Science Citation Index Expanded, and the Cochrane Central Register of Controlled Trials from date of inception through August 2017 for studies reporting pregnancy with kidney transplant.

Results

Of 1343 unique studies, 87 met inclusion criteria, representing 6712 pregnancies in 4174 kidney transplant recipients. Mean maternal age was 29.6?±?2.4?years. The live-birth rate was 72.9% (95% CI, 70.0-75.6). The rate of other pregnancy outcomes was as follows: induced abortions (12.4%; 95% CI, 10.4-14.7), miscarriages (15.4%; 95% CI, 13.8-17.2), stillbirths (5.1%; 95% CI, 4.0-6.5), ectopic pregnancies (2.4%; 95% CI, 1.5-3.7), preeclampsia (21.5%; 95% CI, 18.5-24.9), gestational diabetes (5.7%; 95% CI, 3.7-8.9), pregnancy induced hypertension (24.1%; 95% CI, 18.1-31.5), cesarean section (62.6, 95% CI 57.6-67.3), and preterm delivery was 43.1% (95% CI, 38.7-47.6). Mean gestational age was 34.9?weeks, and mean birth weight was 2470?g. The 2-3-year interval following kidney transplant had higher neonatal mortality, and lower rates of live births as compared to >?3?year, and??35?years as compared to women aged 25-34?years.

Conclusion

Although the outcome of live births is favorable, the risks of maternal and fetal complications are high in kidney transplant recipients and should be considered in patient counseling and clinical decision making.

SUBMITTER: Shah S

PROVIDER: S-EPMC6345071 | biostudies-literature | 2019 Jan

REPOSITORIES: biostudies-literature

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Publications

Pregnancy outcomes in women with kidney transplant: Metaanalysis and systematic review.

Shah Silvi S Venkatesan Renganathan Lalgudi RL Gupta Ayank A Sanghavi Maitrik K MK Welge Jeffrey J Johansen Richard R Kean Emily B EB Kaur Taranpreet T Gupta Anu A Grant Tiffany J TJ Verma Prasoon P

BMC nephrology 20190123 1

<h4>Background</h4>Reproductive function in women with end stage renal disease generally improves after kidney transplant. However, pregnancy remains challenging due to the risk of adverse clinical outcomes.<h4>Methods</h4>We searched PubMed/MEDLINE, Elsevier EMBASE, Scopus, BIOSIS Previews, ISI Science Citation Index Expanded, and the Cochrane Central Register of Controlled Trials from date of inception through August 2017 for studies reporting pregnancy with kidney transplant.<h4>Results</h4>O ...[more]

PMID: 30674290

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Project description:Polycystic ovary syndrome (PCOS) is a common metabolic problem in women of reproductive age. Evidence suggests pregnant women with PCOS may have a higher risk of the development of adverse pregnancy outcomes; however, the relationship between pre-pregnancy overweight/obesity and pregnancy outcomes in women with PCOS remains uncertain. We try to clarify the relationship between pre-pregnancy overweight/obesity and subsequent pregnancy outcomes. Therefore, we conducted this systematic review and meta-analysis. We used the databases obtained from the PubMed, Embase, Web of Science, and Cochrane databases, plus hand-searching, to examine the association between pre-pregnancy overweightness/obesity and pregnancy outcomes in women with PCOS from inception to 4 February 2022. A total of 16 cohort studies, including 14 retrospective cohort studies (n = 10,496) and another two prospective cohort studies (n = 818), contributed to a total of 11,314 women for analysis. The meta-analysis showed significantly increased odds of miscarriage rate in PCOS women whose pre-pregnancy body mass index (BMI) is above overweight (OR 1.71 [95% CI 1.38-2.11]) or obese (OR 2.00 [95% CI 1.38-2.90]) under a random effect model. The tests for subgroup difference indicated the increased risk was consistent, regardless which body mass index cut-off for overweight (24 or 25 kg/m2) or obesity (28 and 30 kg/m2) was used. With the same strategies, we found that pregnant women in the control group significantly increased live birth rate compared with those pregnant women with PCOS as well as pre-pregnancy overweight/obesity (OR 0.79 [95% CI 0.71-0.89], OR 0.78 [95% CI 0.67-0.91]). By contrast, we did not find any association between PCOS women with pre-pregnancy overweight/obesity and preterm birth. Based on the aforementioned findings, the main critical factor contributing to a worse pregnancy outcome may be an early fetal loss in these PCOS women with pre-pregnancy overweight/obesity. Since PCOS women with pre-pregnancy overweightness/obesity were associated with worse pregnancy outcomes, we supposed that weight reduction before attempting pregnancy in the PCOS women with pre-pregnancy overweightness/obesity may improve the subsequent pregnancy outcomes.

Dataset Information

Pregnancy outcomes in women with kidney transplant: Metaanalysis and systematic review.

Background

Methods

Results

Conclusion

Publications

Pregnancy outcomes in women with kidney transplant: Metaanalysis and systematic review.

Similar Datasets

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