Risk of adverse maternal and fetal outcomes during pregnancy in living kidney donors

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Record number: 
Adverse Occurrence type: 
MPHO Type: 
Estimated frequency: 
Fifty-nine women with a history of kidney donation prior to their first pregnancy with normal renal function and no history of kidney disease, diabetes or chronic hypertension were matched 1:4 by age (within 2 years) and race to women with two kidneys using data from an integrated healthcare delivery system. Living kidney donors did not have a higher risk of adverse pregnancy-related outcomes compared to matched controls. There was a trend towards an increased risk of preeclampsia/eclampsia in kidney donors but it did not reach statistical significance (OR 2.96, 95% CI 0.98–8.94, p=0.06). However, in kidney donors ≤ 30 years of age, there was a 4-fold increased risk of preeclampsia/ eclampsia (OR 4.09, 95% CI 1.07-15.59, p=0.04).
Time to detection: 
A variety of pregnancy-related outcomes were investigated from delivery through several days post-delivery.
Alerting signals, symptoms, evidence of occurrence: 
Adverse pregnancy outcomes were defined as preterm delivery (delivery < 37 weeks), delivery via cesarean section, gestational hypertension, preeclampsia/eclampsia, gestational diabetes, length of stay in the hospital > 3 days, infant death/transfer to acute facility and low birth weight (<2,500 gm).
Demonstration of imputability or root cause: 
This is a case-control study so evidence of imputability is good.
Imputability grade: 
2 Probable
Groups audience: 
Suggest new keywords: 
living kidney donation, pregnancy risk
Reference attachment: 
Suggest references: 
Risk of adverse maternal and fetal outcomes during pregnancy in living kidney donors: A matched cohort study. Clin Transplant. 2019 Jan;33(1):e13453.
Expert comments for publication: 
Overall, the risk of pregnancy-associated complications following kidney donation is small but potential female kidney donors should be counseled on the possible increased risk of preeclampsia, particularly among donors 30 years of age or younger.