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 r ecipients since the introduction of CyA. Methods Using a community based approach, we identified 29 pregnancies in 1 9 women, aged between 16 and 45, mean age 30.3 years. Results These pregnancies ended in four miscarriages (13%), two intra-uteri ne deaths (6.9%) and 23 live births (79.3%). Of these live births, 73.9% we re premature (less than or equal to 36 weeks) and 65.2% were of low birth w eight (<2500g), Admission to the neonatal intensive care was necessary in 6 1%, 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 graf t function during pregnancy, with a small rise in serum creatinine post-par tum (+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 liv e 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 se rum creatinine is >175 mu mol/L.