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Most pregnancies after living kidney donation uncomplicated, Canadian study finds
By Emily Leighton
New research examines pregnancy outcomes among kidney donors, providing clearer evidence to inform donation decisions
By Emily Leighton
Most pregnancies after living kidney donation are uncomplicated, according to a new Canadian study that provides a clearer picture of pregnancy outcomes among kidney donors.
The study, published in JAMA and led by researchers at Western University and London Health Sciences Centre Research Institute (LHSCRI), compared pregnancies among living kidney donors in Ontario, Alberta and British Columbia with those of women in similarly good health who had not donated.
“For many potential donors, the decision isn’t just about their health today, but what life might look like years down the road,” said Dr. Amit Garg, senior author of the study and professor at Western’s Schulich School of Medicine & Dentistry.
We want people to have the clearest possible information about what donation could mean for them, including if they hope to have children.
Professor, Departments of Medicine and Epidemiology and Biostatistics
Using provincial health-care data, including data from ICES, researchers compared 385 pregnancies among kidney donors with 1,540 pregnancies among women who had not donated.
Most pregnancy outcomes examined were similar between the two groups. Rates of gestational diabetes, caesarean delivery, premature birth and neonatal intensive care admissions were comparable, as were rates of serious maternal complications and postpartum hemorrhage.
The researchers did identify a small increased risk of hypertensive disorders, which involve high blood pressure during pregnancy. Among kidney donors, 11.9 per cent of pregnancies involved hospitalization with gestational hypertension, preeclampsia or eclampsia, compared with 8.3 per cent among non-donors.
The study also found that babies born to kidney donors were more likely to be smaller than expected for their stage of pregnancy. Researchers say further investigation is needed to confirm this secondary finding.
The research builds on an earlier Ontario study involving 131 pregnancies after kidney donation. By expanding the scope to 385 donor pregnancies across three provinces, the team was able to provide more precise estimates of pregnancy-related risks.
Garg, a nephrologist at London Health Sciences Centre, scientist at LHSCRI and senior scientist at ICES, has counselled more than 1,000 prospective kidney donors over the past two decades.
“Understanding the magnitude of risk, and when complications are most likely to occur, gives us a much better foundation for conversations with prospective donors,” he said. “These findings can help people make informed decisions and guide their care during pregnancy.”