J Korean Soc Pediatr Nephrol > Volume 4(1); 2000 > Article
J Korean Soc Pediatr Nephrol 2000;4(1): 77-83.
신이식을 받은 산모로부터 출생한 소아의 성장상태
기미나, 육진원, 김지홍, 김병길, 문장일, 김순일, 김유선, 박기일, 박용원
1연세대학교 의과대학 소아과학교실
2연세대학교 의과대학 소아과학교실
3연세대학교 의과대학 소아과학교실
4연세대학교 의과대학 소아과학교실
5연세대학교 의과대학 이식외과학교실
6연세대학교 의과대학 이식외과학교실
7연세대학교 의과대학 이식외과학교실
8연세대학교 의과대학 이식외과학교실
9연세대학교 의과대학 산부인과학교실
Current Status of Children Born from Renal Transplanted Mother
Mina Ki, Jinwon Yook, Ji Hong Kim, Pyung-Kil Kim, Jang Il Moon, Soon Il Kim, Yu Seun Kim, Kiil Park, Young Won Park
1Department of Pediatrics, Yonsei University, College of Medicine
2Department of Pediatrics, Yonsei University, College of Medicine
3Department of Pediatrics, Yonsei University, College of Medicine
4Department of Obstetrics & Gynecology, Korea University, College of Medicine
5Department of Pediatrics, Yonsei University, College of Medicine
6Department of Surgery, Yonsei University, College of Medicine
7Department of Surgery, Yonsei University, College of Medicine
8Department of Surgery, Yonsei University, College of Medicine
9Department of Surgery, Yonsei University, College of Medicine
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Purpose: Pregnancy in transplanted mother is considered as a high-risk pregnancy, and significant incidences of prematurity and low-birthweight(LBW) infants have been reported. The objective of this study is to examine the outcome of pregnancy in transplanted mothers and to evaluate the current growth status in their children.
Patients and Methods : We retrospectively reviewed 54 pregnancies in 40 kidney recipients until June 1999. Outcomes of pregnancy were reviewed and assessment of the current growth status in children was performed.
Results : 54 pregnancies in 40 recipients were identified; 22 ended in termination of pregnancy because of unwanted pregnancy or therapeutic purposes. And of the other 32, 29 livebirths resulted in 28 recipients. The mean age of conception was $30.3{pm}3.8$ years, with a mean interval from transplantation to conception of $35.9{pm}23.2$ months. All patients were maintained on immunosuppressive regimens. Incidence of drug-treated hypertension(HTN) prior to pregancy was $52%$, HTN during pregnancy, $48%$; preeclampsia, $41%$; urinary tract infection, $48%$; oligohydramnios $4%$; and no rejection during pregnancy and up to 3month post delivery. Of the 29 liveborn infants, prematurity(<37wk) occurred in $52%$, LBW(<2500g) in $62%$, VLBW(<1500g) in $7%$ and $48%$ born intrauterine growth retardation(IUGR). Mean gestational age was $36.3{pm}3.0;wk$; a mean birthweight, $2.23{pm}0.6;kg$; a mean birth-height, $45.1{pm}3.6cm$. Current mean height standard deviation score (height SDS) was $0.29{pm}0.91$ and mean weight SDS was $0.62{pm}1.34$. 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 : This study showed similar incidence of premaure birth($57%$) and low birth weight infants($62%$), but lower incidence of spontaneous abortion($5.6%$) was observed and compared to other studies. Postnatal growth in majority of children($96%$) achieved catch-up growth before 1 year. Present study supports a more optimistic view of pregnancy in renal transplant mother and normal growth in their children.
Key words: Transplantation | Pregnancy | Offspring | Kidney
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