722: Maternal solid organ transplantation and pregnancy outcome; a national population-based cohort study

Abstract

outcome; a national population-based cohort study Nils-Halvdan Morken, Cesar Diaz-Garcia, Mats Brannstrom University of Bergen, Public Health and Primary Health care, Bergen, Norway, University of Valencia, Gynecology and Obstetrics, Valencia, Spain, University of Gothenburg, Obstetrics and Gynecology, Valencia, Sweden OBJECTIVE: The first pregnancy with a live birth after solid organ transplantation in the human occurred more than 50 years ago. Still, knowledge about this very special patient group is limited. The objective was to assess the risk of adverse pregnancy outcome after transplant compared to pregnancies before transplant in females. We also compared the risk after transplant with the general population. STUDY DESIGN: A national population-based cohort study on data from the Medical Birth Registry of Norway (MBRN) during 1967 to 2009 was performed. Record linkage with the Norwegian Renal Registry (NRR), local databases at The National Hospital in Oslo, the Nordic Liver Transplant Registry (NLTR) and Scandia transplant databases were performed to obtain information on all transplanted females in Norway. Risk estimates were obtained using logistic regression analysis and adjustments for various confounding factors were performed. RESULTS: A total of 2 269 deliveries before and 169 deliveries after transplant in females were identified. Only the risk of caesarean section (AOR: 2.9, 95%CI: 1.9-4.4) was increased when pregnancies after transplant were compared to pregnancies before transplant. When pregnancies after transplant were compared to the general population several outcomes were increased such as: preeclampsia (AOR: 2.8, 95%CI: 1.9-4.0) , bleeding during pregnancy (AOR: 1.5, 95%CI: 1.042.3), caesarean section (AOR: 6.6, 95%CI: 4.7-9.3), SGA (AOR: 1.6, 95%CI: 1.1-2.3) , LBW (AOR: 2.0, 95%CI: 1.2-3.2) and preterm delivery (AOR: 2.8, 95%CI: 1.3-6.4). CONCLUSION: Compared to the general population, transplanted women are a group of patients at high risk. Transplant per se or immunosuppressant treatment seems to ad little extra risk when pregnancies after transplant were compared to pregnancies before transplant.