269. Impact of hypertension in pregnancy outcomes and graft function in kidney transplanted women

Abstract

Introduction Hypertension, elevated serum creatinine and proteinuria are prepregnancy factors described in association with adverse pregnancy outcomes and graft dysfunction. Obstetric and neonatal complications include preeclampsia, gestational diabetes mellitus (GDM), intrauterine growth restriction (IUGR), preterm delivery, cesarean section, low and very low birth weight (LBW/VLBW). Objective/hypothesis To evaluate obstetric, neonatal and graft outcomes in kidney transplanted women with prepregnancy hypertension. Methods Retrospective and comparative analyses of 41 pregnancies in 33 renal recipients followed in our department from 1989 to 2017. We considered two groups: women with prepregnancy hypertension (group 1) and women without prepregnancy hypertension (group 2 – control group). Statistical analysis was performed using IBM SPSS® Statistics v22 (p-value Results There were 13 (31.7%) pregnancies in group 1 and 28 (68.3%) in group 2. The mean maternal age, mean time between transplant and pregnancy and mean prepregnancy serum creatinine were similar in both groups. The incidence of GDM (25.0% vs 4.2%, p = 0.07), preeclampsia (16.7% vs 8.3%, p = 0.47), anemia (50.0% vs 20.8%, p = 0.08), IUGR (41.7% vs 12.5%, p = 0.05) and preterm delivery (66.7% vs 54.2%, p = 0.47) was higher in group 1. All cases of preeclampsia were diagnosed before 34 weeks in this group. Newborns with LBW (75.0% vs 45.8%, p = 0.09) and VLBW (33.3% vs 0.0%, p Discussion According to our results, prepregnancy hypertension is associated with worse obstetric and neonatal outcomes in pregnancies after kidney transplantation, although it seems to have no impact on graft function.