NEONATAL OUTCOMES AFTER UTERUS TRANSPLANT- DUETS (DALLAS UTERUS TRANSPLANT STUDY)

Abstract

Uterus transplantation is restoring fertility in women absolute uterine-factor infertility and allows them to experience gestation and childbirth. Limited data are available on the outcome of infants born after uterus transplantation. Our aim was to describe the hospital course and laboratory findings of the first 6 infants born in the Dallas UtErus Transplant Study (DUETS). Prospective review. Twenty women received a uterus transplant at Baylor University Medical Center in Dallas (a tertiary referral center) from 2016 to 2019 (NCT02656550). Based on the trial protocol, information about the first 6 infants delivered was collected in a prospective fashion, including infant demographics, hospital course, and laboratory values. Six infants were delivered, all by cesarean section, from mothers who had undergone uterus transplantation. All mothers had an immunosuppressive regimen and none experienced an episode of rejection during pregnancy. The infants had a median gestational age of 36.3 weeks (range 30.6–37.2 weeks) and median birthweight of 2890 g (range 1771–3140 g). APGAR scores were at least 7 at 1 minute and at least 8 at 5 minutes. All were appropriate size for gestational age. Two infants had complete blood counts with bandemia but negative blood cultures. Blood urea nitrogen and creatinine levels were within expected range. The 6 infants born from mothers with uterus transplants had a neonatal course that reflected the gestational age at delivery. No baby was born with an identified deformation or malformation attributed to the transplantation or immunosuppression. Despite exposure to a calcineurin inhibitor throughout pregnancy, there were no adverse effects on renal function. Longer follow-up and a larger number of infants are needed to confirm these observations.