Pregnancy Outcomes After Kidney Donation

The outcome of pregnancy in kidney donors has generally
been viewed to be favorable. We determined fetal
and maternal outcomes in a large cohort of kidney
donors. A total of 2102 women have donated a
kidney at our institution; 1589 donors responded to
our pregnancy surveys; 1085 reported 3213 pregnancies
and 504 reported none. Fetal and maternal outcomes
in postdonation pregnancies were comparable
to published rates in the general population. Postdonation
(vs. predonation) pregnancies were associated
with a lower likelihood of full-term deliveries (73.7%
vs. 84.6%, p = 0.0004) and a higher likelihood of fetal
loss (19.2% vs. 11.3%, p < 0.0001). Postdonation
pregnancies were also associated with a higher risk
of gestational diabetes (2.7% vs. 0.7%, p = 0.0001),
gestational hypertension (5.7% vs. 0.6%, p < 0.0001),
proteinuria (4.3% vs. 1.1%, p < 0.0001) and preeclampsia
(5.5% vs. 0.8%, p < 0.0001). Women who had both
pre- and post-donation pregnancies were also more
likely to have these adverse maternal outcomes in their
postdonation pregnancies. In this large survey of previous
living donors in a single center, fetal and maternal
outcomes and pregnancy outcomes after kidney
donation were similar to those reported in the general
population, but inferior to predonation pregnancy
outcomes.