Yasemin DOĞAN, Göktuğ FIRATLI, Mehmet Zeki TÜRE, Ercan KOÇKAYA, Müzeyyen Dilşad ESER, Sibel Gökçay BEK, Erkan DERVİŞOĞLU
Turkish Journal of Nephrology - 2026;35(2):136-145
Background: This study aims to assess the clinical course and pregnancy outcomes after kidney transplantation and investigate the function of kidney grafts. Methods: This retrospective cohort analysis included 17 pregnancies in 14 patients with a history of kidney transplantation, who were followed up at a single tertiary hospital. Sociodemographic data, medical history, obstetric data, and laboratory parameters in each trimester, as well as before, within 24 hours, and 6 months after delivery, were collected. Results: Among the 17 pregnancies, 1 patient had an abortion, 1 had dilatation and curettage, and 3 had 2 pregnancies during the study period. One woman had a twin pregnancy. The median serum creatinine concentration before conception was 0.8 (0.8-0.9) mg/dL. The median time interval between kidney transplantation and pregnancy was 78 months (interquartile range: 42-138 months). Serum creatinine levels were higher and estimated glomerular filtration rates were lower in the third trimester than in the pre-pregnancy, first, and second trimesters. The urinary protein-to-creatinine ratio was higher in the third trimester. None of the patients experienced graft rejection during pregnancy. Fourteen pregnancies resulted in live births; 8 patients had preeclampsia (53%); 11 neonates were born prematurely (73%); and 8 of the babies were small for gestational age (53%). Conclusion: The short-term impact of pregnancy on allograft function appears to be acceptable despite a statistically significant increase in serum creatinine levels during the third trimester. However, close surveillance is mandatory in pregnancies after kidney transplantation, because it confers a greater risk of obstetric complications.
