Kidney Res Clin Pract  
Maternal and fetal outcomes of pregnancies in kidney donors: A 30-year comparative analysis of matched non-donors in a single center
Kyung Don Yoo1,*, Hajeong Lee2,*, Yaerim Kim2, Sehoon Park2, Joong Shin Park3, Joon Seok Hong4, Chang Wook Jeong5, Hyeon Hoe Kim5, Jung Pyo Lee6, Dong Ki Kim2, Kook-Hwan Oh2, Kwon Wook Joo2, Yon Su Kim2
1Department of Internal Medicine, Dongguk University College of Medicine, Gyeongju, Korea
2Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
3Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul, Korea
4Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Korea
5Department of Urology, Seoul National University College of Medicine, Seoul, Korea
6Department of Internal Medicine, SMG-SNU Boramae Medical Center, Seoul, Korea
Correspondence to: Yon Su Kim
Department of Internal Medicine, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea. E-mail: onsukim@snu.ac.kr
Received: May 28, 2018; Revised: September 24, 2018; Accepted: October 5, 2018; Published online: November 19, 2018.
© The Korean Society of Nephrology. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Woman kidney donors face obstetric complication risks after kidney donation, such as gestational hypertension and preeclampsia. Studies on childbirth-related complications among Asian women donors are scarce.
Methods: This retrospective cohort study included woman donors aged 45 years or younger at the time of kidney donation in a single tertiary hospital between 1985 and 2014. Pregnancy associated complications were investigated using medical records and telephone questionnaires for 426 pregnancies among 225 donors. Matched non-donor controls were selected by propensity score and the maternal and fetal outcomes were compared with those of donors. Primary outcomes were differences in maternal complications, and secondary outcomes were fetal outcomes in pregnancies of the donor and control groups.
Results: A total of 56 donors had post-donation pregnancies. The post-donation pregnancies group was younger at the time of donation and older at the time of delivery than the pre-donation pregnancies group, and there were no differences in primary outcomes between the groups except the proportion receiving cesarean section. Comparison of the complication risk between post-donation pregnancies and non-donor matched controls showed no significant differences in gestational hypertension, preeclampsia, or composite outcomes after propensity score matching including age at delivery, era at pregnancy, systolic blood pressure, body weight, and estimated glomerular filtration ratio (odds ratio, 0.63; 95% confidence interval, 0.19-2.14; P = 0.724).
Conclusion: This study revealed that maternal and fetal outcomes between woman kidney donors and non-donor matched controls were comparable. Studies with general population pregnancy controls are warranted to compare pregnancy outcomes for donors.
Keywords: Donor, Pregnancy outcome, Tissue donors


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