文本框: CURRENT GROWTH STATUS OF CHILDREN BORN FROM RENAL TRANSPLANT MOTHER
Lee YM1, Kim PK1, Yook JW1, Ki MN1, Kim JH1, Moon JI2, Kim SI2, Kim YS2, Park K2
1 Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
2 Department of Surgery, Yonsei University College of Medicine, Seoul, Korea

Objective: Pregnacy in renal transplant mother is considered as a high-risk pregnancy, and significant incidences of pre-term delivery and low birth weight (LBW) infants have been reported. Objective of this study was to examine the outcome of pregnancy in renal transplant mothers and evaluate current growth ststus in children.
Methods: 54 pregnancies in 40 recipients were identified; 22 ended in termination of pregnancy because of unwanted pregnancy or therapeutic purposes. Of the other 32, 29 live births resulted in 28 recipients. Pregnancy outcomes were reviewed retrospectively and current growth ststus of children was evaluated.
Results: Mean age of conception was 30.3 ± 3.8 years, with a mean interval from transplantation to conception of 35.9 ± 23.2 months. Immunosuppressive regimens were as follows: CsA + steroids for 25 recipients (89%); CsA for 2 (8%), FK506 + steroids for one (4%). Incidence of drug-treated hypertension (HTN) prior to pregnancy was 52%; HTN during pregnancy 48%; preeclampsia 41%; urinary tract infection 48%; oligohydramnios 4%. Of 29 liveborn infants, prematurity (<37wk) occurred in 52%, LBW (<2500g) in 62%, and 48% born intra-uterine growth retardation (IUGR). Mean gestational age was 36.3 ± 3.0 weeks; a mean birth weight, 2.23 ± 0.6kg; a mean birth-height, 45.1 ± 3.6cm. Current mean height standard deviation score (SDS) was 0.28 ± 0.89 and mean weight SDS was 0.64 ± 1.31. Only one child (4%) under 1 year of age was below 10 percentile in height. Most of children had no medical problems except for 4 children; cleft palate (1), tuberous sclerosis (1), essential hematuria (1), and one child expired due to sepsis.
Conclusion: 91% of pregnancy resulted in live births and history of drug treated HTN prior to pregnancy was associated with a higher incidence of prematurity and LBW. Postnatal growth in majority of children (96%) achieved catch-up growth before 1 year.

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