Document Detail

Prednisone dosage and pregnancy outcome in renal allograft recipients.
MedLine Citation:
PMID:  9141008     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The literature contains reports of 2309 pregnancies in some 1600 women who have undergone renal transplantation. Certain pre-pregnancy factors, especially hypertension, renal graft dysfunction, short interval between transplant and pregnancy, and high immunosuppressive drug dosage, appear to increase the neonatal risks. METHOD: We describe the outcome of 42 pregnancies in 27 allograft recipients at Rabin Medical Center (Beilinson Campus) in Israel during the last 8 years. All were treated with combination immunosuppression regimens. RESULTS: The average interval from transplantation to conception was 3.7 +/- 0.4 years (2 months to 9 years). Rejection episodes occurred in 37% prior to pregnancy but in none during or immediately after pregnancy. Twenty-eight percent of the pregnancies ended in therapeutic or spontaneous abortions, and 29 of the 30 deliveries ended in a live birth. The prematurity rate (63%) was similar to that described in the literature for this patient group. Renal deterioration was evident in seven women (26%) within 2 years after delivery. Use of 7.5 mg/d prednisone (vs. 10 mg/d) before pregnancy was observed as the most significant preconception parameter related to better pregnancy outcome. A long interval from transplantation to conception and lack of pre-existing hypertension were also significant. CONCLUSION: The better pregnancy outcome associated with lower prednisone dosage is probably related to the fact that the patients selected to receive the low-dose regimen have had a longer and less complicated post-transplantation course.
J Bar; B Fisch; C Wittenberg; I Gelerenter; G Boner; M Hod
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association     Volume:  12     ISSN:  0931-0509     ISO Abbreviation:  Nephrol. Dial. Transplant.     Publication Date:  1997 Apr 
Date Detail:
Created Date:  1997-07-18     Completed Date:  1997-07-18     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8706402     Medline TA:  Nephrol Dial Transplant     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  760-3     Citation Subset:  IM    
Department of Obstetrics and Gynecology, Rabin Medical Center, Peath Tiqva, Israel.
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MeSH Terms
Abortion, Spontaneous / etiology
Cesarean Section
Fetal Growth Retardation / etiology
Immunosuppressive Agents / administration & dosage*,  adverse effects*
Infant, Newborn
Kidney Transplantation / adverse effects,  immunology,  physiology*
Pre-Eclampsia / etiology
Prednisone / administration & dosage*,  adverse effects*
Pregnancy Outcome
Risk Factors
Time Factors
Reg. No./Substance:
0/Immunosuppressive Agents; 53-03-2/Prednisone

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