Children of renal transplant recipient mothers

Objective: To assess the current physical status and developmental outcome of children born to mothers following renal transplantation. Methodology: A cross-sectional prevalence survey of 48 children born to 34 women transplanted at a single centre from 1971 to 1992 was performed. Data on maternal renal disease, immunosuppression, pregnancy, delivery and chil d development were collected using hospital records and parental questionna ire. Children underwent physical examination, urinalysis and urinary tract ultrasound examination (US). Results: Maternal renal failure was due to reflux nephropathy/chronic pyelo nephritis (16), chronic glomerulonephritis (eight) and other causes (10). A ll mothers received prednisolone immunosuppression, as sole therapy (one), as part of triple therapy (one). Sixteen (47%) received azathioprine/predni solone and 16 (47%) cyclosporin/prednisolone. Twenty-three girls and 25 boy s aged 9 months to 18 years were studied (median age 5.2 years); 27/48 (56% ) were born prematurely, 21/48 (44%) with birthweight (BW) < 2500 g 21/48 ( 44%) were small for gestation (BW < 10th centile). General health and physi cal assessment were unremarkable in 45/48 (94%) and 41/43 (95%), respective ly. Development was considered normal in 47/48 (98%). Four of 40 (10%) had urinary tract abnormalities on US. Conclusions: Despite a high incidence of preterm delivery, low birth weight , intrauterine growth retardation and urinary tract abnormalities, the over all outcome for children of renal transplant recipient mothers is good.