Risk of Adverse Maternal and Fetal Outcomes during Pregnancy in Living Kidney Donors: A Matched Cohort Study.

BACKGROUND: We examined the risk of adverse pregnancy outcomes in primiparous kidney donors compared to matched controls.

METHODS: 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. 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).

RESULTS: Living kidney donors did not have a higher risk of adverse 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).

CONCLUSION: 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. This article is protected by copyright. All rights reserved.