Clinical outcomes in patients with unintended pregnancy after liver transplantation: A multicenter registry cohort study.

Autor:	Walia A; University of California San Francisco School of Medicine., Yin O; Division of Maternal Fetal Medicine and Reproductive Genetics, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco., Coscia L; Transplant Pregnancy Registry International, Gift of Life Institute, Philadelphia, PA., Afshar Y; Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California Los Angeles.; Molecular Biology Institute, University of California, Los Angeles., Irani R; Division of Maternal Fetal Medicine and Reproductive Genetics, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco., Constantinescu S; Transplant Pregnancy Registry International, Gift of Life Institute, Philadelphia, PA.; Section of Nephrology, Hypertension, and Kidney Transplantation, Department of Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA., Moritz M; Transplant Pregnancy Registry International, Gift of Life Institute, Philadelphia, PA., Sarkar M; Division of Transplant Hepatology, Department of Medicine, University of California San Francisco.
Jazyk:	angličtina
Zdroj:	Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society [Liver Transpl] 2024 Oct 28. Date of Electronic Publication: 2024 Oct 28.
DOI:	10.1097/LVT.0000000000000524
Abstrakt:	The consequences of unintended pregnancy in liver transplant (LT) recipients, a growing part of the high-risk obstetric population, remain unknown. To fill this gap, we conducted a retrospective registry cohort study to describe the risk factors, obstetric and neonatal morbidity, and graft outcomes associated with unintended pregnancy after LT. This study utilized the Transplant Pregnancy Registry International (TPRI) and included 565 pregnancies of LT recipients between 1967 and 2019 from 289 hospitals, primarily in North America. The primary outcome of acute cellular rejection (ACR) and secondary outcomes of graft loss, severe maternal morbidity, and neonatal composite morbidity were compared by pregnancy intention. The study population included 60.9% with intended pregnancies and 39.1% unintended pregnancies. Recipients with unintended pregnancy were more likely to self-report as Black race, to be younger, nulliparous, and have exposure to teratogenic immunosuppression. ACR was more common with unintended pregnancy (3.7% vs 1.2%, p=0.047). Unintended pregnancies had lower median birth weight (2806.6 vs 2948.4 grams, p=0.033). Unintended pregnancy was not associated with increased neonatal morbidity or severe maternal morbidity. These findings underscore the importance of family planning counseling, access to safe and effective contraceptive options, as well as multidisciplinary prenatal care in the growing population of reproductive-aged LT recipients. (Copyright © 2024 American Association for the Study of Liver Diseases.)
Databáze:	MEDLINE
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