Effect of deflazacort on pregnancy outcome in kidney transplant patients: should we change the immunosuppressant before conception?
Abstract Background Despite the good prognosis in patients with transplant organs, limited evidence is available on how immunosuppressants affect pregnancy. The aim of this study was to determine whether immunosuppressant use affects the pregnancy outcome and to identify whether there is any need to...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2019-05-01
|
| Series: | BMC Nephrology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12882-019-1346-6 |
| _version_ | 1819148890733019136 |
|---|---|
| author | Bo Hyon Yun Dong Jin Joo Seok Kyo Seo Si Hyun Cho Young Sik Choi Byung Seok Lee |
| author_facet | Bo Hyon Yun Dong Jin Joo Seok Kyo Seo Si Hyun Cho Young Sik Choi Byung Seok Lee |
| author_sort | Bo Hyon Yun |
| collection | DOAJ |
| description | Abstract Background Despite the good prognosis in patients with transplant organs, limited evidence is available on how immunosuppressants affect pregnancy. The aim of this study was to determine whether immunosuppressant use affects the pregnancy outcome and to identify whether there is any need to change the immunosuppressant before the patient tries to conceive. Methods This retrospective cohort study included women with previous kidney transplantation history who visited the Department of Obstetrics and Gynecology for either infertility or antenatal care between January 2005 and May 2016. A total of 40 cases (36 women) met the inclusion criteria. Statistical analyses were performed using SAS version 9.4. Results There were no differences in the immunosuppressant regimen between the pregnant and non-pregnant groups (never-pregnant+miscarriage) (P = 0.73). Individual immunosuppressant use was significantly different in terms of pregnancy outcome among the never-pregnant, miscarriage, and clinical pregnancy groups (azathioprine, P = 0.01; deflazacort, P < 0.0001). Only deflazacort use differed significantly between the clinical pregnancy and non-pregnant groups (P = 0.003). After adjusting for factors that may affect pregnancy outcome, deflazacort use remained significantly associated with a decreased odds ratio for clinical pregnancy (P = 0.02). Cox regression analysis also showed that deflazacort use was the only remaining factor that could hinder the success of clinical pregnancy (P = 0.03). Conclusions Our study suggests that the type of immunosuppressive regimen may not affect the success of clinical pregnancy. However, deflazacort may decrease the possibility of clinical pregnancy in women with kidney transplant when they try to conceive. |
| first_indexed | 2024-12-22T13:52:54Z |
| format | Article |
| id | doaj.art-2e09f0d4a8a84d8fb3680dc6e95d0c32 |
| institution | Directory Open Access Journal |
| issn | 1471-2369 |
| language | English |
| last_indexed | 2024-12-22T13:52:54Z |
| publishDate | 2019-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Nephrology |
| spelling | doaj.art-2e09f0d4a8a84d8fb3680dc6e95d0c322022-12-21T18:23:38ZengBMCBMC Nephrology1471-23692019-05-012011910.1186/s12882-019-1346-6Effect of deflazacort on pregnancy outcome in kidney transplant patients: should we change the immunosuppressant before conception?Bo Hyon Yun0Dong Jin Joo1Seok Kyo Seo2Si Hyun Cho3Young Sik Choi4Byung Seok Lee5Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of MedicineDepartment of Transplant Surgery, Severance Hospital, Yonsei University College of MedicineDepartment of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of MedicineInstitute of Women’s Life Medical Science, Yonsei University College of MedicineDepartment of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of MedicineDepartment of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of MedicineAbstract Background Despite the good prognosis in patients with transplant organs, limited evidence is available on how immunosuppressants affect pregnancy. The aim of this study was to determine whether immunosuppressant use affects the pregnancy outcome and to identify whether there is any need to change the immunosuppressant before the patient tries to conceive. Methods This retrospective cohort study included women with previous kidney transplantation history who visited the Department of Obstetrics and Gynecology for either infertility or antenatal care between January 2005 and May 2016. A total of 40 cases (36 women) met the inclusion criteria. Statistical analyses were performed using SAS version 9.4. Results There were no differences in the immunosuppressant regimen between the pregnant and non-pregnant groups (never-pregnant+miscarriage) (P = 0.73). Individual immunosuppressant use was significantly different in terms of pregnancy outcome among the never-pregnant, miscarriage, and clinical pregnancy groups (azathioprine, P = 0.01; deflazacort, P < 0.0001). Only deflazacort use differed significantly between the clinical pregnancy and non-pregnant groups (P = 0.003). After adjusting for factors that may affect pregnancy outcome, deflazacort use remained significantly associated with a decreased odds ratio for clinical pregnancy (P = 0.02). Cox regression analysis also showed that deflazacort use was the only remaining factor that could hinder the success of clinical pregnancy (P = 0.03). Conclusions Our study suggests that the type of immunosuppressive regimen may not affect the success of clinical pregnancy. However, deflazacort may decrease the possibility of clinical pregnancy in women with kidney transplant when they try to conceive.http://link.springer.com/article/10.1186/s12882-019-1346-6Kidney transplantImmunosuppressantPregnancy |
| spellingShingle | Bo Hyon Yun Dong Jin Joo Seok Kyo Seo Si Hyun Cho Young Sik Choi Byung Seok Lee Effect of deflazacort on pregnancy outcome in kidney transplant patients: should we change the immunosuppressant before conception? BMC Nephrology Kidney transplant Immunosuppressant Pregnancy |
| title | Effect of deflazacort on pregnancy outcome in kidney transplant patients: should we change the immunosuppressant before conception? |
| title_full | Effect of deflazacort on pregnancy outcome in kidney transplant patients: should we change the immunosuppressant before conception? |
| title_fullStr | Effect of deflazacort on pregnancy outcome in kidney transplant patients: should we change the immunosuppressant before conception? |
| title_full_unstemmed | Effect of deflazacort on pregnancy outcome in kidney transplant patients: should we change the immunosuppressant before conception? |
| title_short | Effect of deflazacort on pregnancy outcome in kidney transplant patients: should we change the immunosuppressant before conception? |
| title_sort | effect of deflazacort on pregnancy outcome in kidney transplant patients should we change the immunosuppressant before conception |
| topic | Kidney transplant Immunosuppressant Pregnancy |
| url | http://link.springer.com/article/10.1186/s12882-019-1346-6 |
| work_keys_str_mv | AT bohyonyun effectofdeflazacortonpregnancyoutcomeinkidneytransplantpatientsshouldwechangetheimmunosuppressantbeforeconception AT dongjinjoo effectofdeflazacortonpregnancyoutcomeinkidneytransplantpatientsshouldwechangetheimmunosuppressantbeforeconception AT seokkyoseo effectofdeflazacortonpregnancyoutcomeinkidneytransplantpatientsshouldwechangetheimmunosuppressantbeforeconception AT sihyuncho effectofdeflazacortonpregnancyoutcomeinkidneytransplantpatientsshouldwechangetheimmunosuppressantbeforeconception AT youngsikchoi effectofdeflazacortonpregnancyoutcomeinkidneytransplantpatientsshouldwechangetheimmunosuppressantbeforeconception AT byungseoklee effectofdeflazacortonpregnancyoutcomeinkidneytransplantpatientsshouldwechangetheimmunosuppressantbeforeconception |