{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T08:49:47Z","timestamp":1778834987362,"version":"3.51.4"},"reference-count":39,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2021,7,19]],"date-time":"2021-07-19T00:00:00Z","timestamp":1626652800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>This study aimed to assess outcomes of delivery hospitalizations, including acute kidney injury (AKI), obstetric and foetal events and resource utilization among pregnant women with kidney transplants compared with pregnant women with no known kidney disease and those with chronic kidney disease (CKD) Stages 3\u20135.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Hospitalizations for delivery in the US were identified using the enhanced delivery identification method in the National Inpatient Sample dataset from the years 2009 to 2014. Diagnoses of CKD Stages 3\u20135, kidney transplantation, along with obstetric events, delivery methods and foetal events were identified using ICD\u20109\u2010CM diagnosis and procedure codes. Patients with no known kidney disease group were identified by excluding any diagnoses of CKD, end stage kidney disease, and kidney transplant. Multivariable logistic regression accounting for the survey weights and matched regression was conducted to investigate the risk of maternal and foetal complications in women with kidney transplants, compared with women with no kidney transplants and no known kidney disease, and to women with CKD Stages 3\u20135.<\/jats:p><\/jats:sec><jats:sec><jats:title>Result<\/jats:title><jats:p>A total of 5,\u2009408,\u2009215 hospitalizations resulting in deliveries were identified from 2009 to 2014, including 405 women with CKD Stages 3\u20135, 295 women with functioning kidney transplants, and 5,\u2009405,\u2009499 women with no known kidney disease. Compared with pregnant women with no known kidney disease, pregnant kidney transplant recipients were at higher odds of hypertensive disorders of pregnancy (OR\u00a0=\u00a03.11, 95% CI [2.26, 4.28]), preeclampsia\/eclampsia\/HELLP syndrome (OR\u00a0=\u00a03.42, 95% CI [2.54, 4.60]), preterm delivery (OR\u00a0=\u00a02.46, 95% CI [1.75, 3.45]), foetal growth restriction (OR\u00a0=\u00a01.74, 95% CI [1.01, 3.00]) and AKI (OR\u00a0=\u00a010.46, 95% CI [5.33, 20.56]). There were no significant differences in rates of gestational diabetes or caesarean section. Pregnant women with kidney transplants had 1.30\u2010times longer lengths of stay and 1.28\u2010times higher costs of hospitalization. However, pregnant women with CKD Stages 3\u20135 were at higher odds of AKI (OR\u00a0=\u00a05.29, 95% CI [2.41, 11.59]), preeclampsia\/eclampsia\/HELLP syndrome (OR\u00a0=\u00a01.72, 95% CI [1.07, 2.76]) and foetal deaths (OR\u00a0=\u00a03.20, 95% CI [1.06, 10.24]), and had 1.28\u2010times longer hospital stays and 1.37\u2010times higher costs of hospitalization compared with pregnant women with kidney transplant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Pregnant women with kidney transplant were more likely to experience adverse events during delivery and had longer lengths of stay and higher total charges when compared with women with no known kidney disease. However, pregnant women with moderate to severe CKD were more likely to experience serious complications than kidney transplant recipients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nep.13938","type":"journal-article","created":{"date-parts":[[2021,7,9]],"date-time":"2021-07-09T09:28:02Z","timestamp":1625822882000},"page":"879-889","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Comparison of hospitalization outcomes for delivery and resource utilization between pregnant women with kidney transplants and chronic kidney disease in the United States"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1707-9988","authenticated-orcid":false,"given":"Api","family":"Chewcharat","sequence":"first","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Medicine Mayo Clinic Rochester Minnesota USA"},{"name":"Department of Medicine, Mount Auburn Hospital Harvard Medical School Cambridge Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7228-9876","authenticated-orcid":false,"given":"Andrea G.","family":"Kattah","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Medicine Mayo Clinic Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8313-3604","authenticated-orcid":false,"given":"Charat","family":"Thongprayoon","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Medicine Mayo Clinic Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9954-9711","authenticated-orcid":false,"given":"Wisit","family":"Cheungpasitporn","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Medicine Mayo Clinic Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3022-8861","authenticated-orcid":false,"given":"Boonphiphop","family":"Boonpheng","sequence":"additional","affiliation":[{"name":"Department of Medicine University of California, Los Angeles Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8930-4611","authenticated-orcid":false,"given":"Maria L.","family":"Gonzalez Suarez","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Medicine Mayo Clinic Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iasmina M.","family":"Craici","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Medicine Mayo Clinic Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6891-0578","authenticated-orcid":false,"given":"Vesna D.","family":"Garovic","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Medicine Mayo Clinic Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,7,19]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2011.03607.x"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-6386(12)81116-4"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1159\/000064079"},{"key":"e_1_2_7_5_1","first-page":"65","article-title":"Report from the National Transplantation Pregnancy Registry (NTPR): outcomes of pregnancy after transplantation","author":"Coscia LA","year":"2010","journal-title":"Clin Transpl"},{"issue":"3","key":"e_1_2_7_6_1","first-page":"S1","article-title":"Clinical practice guideline for the care of kidney transplant recipients","volume":"9","author":"KDIGO","year":"2009","journal-title":"Am J Transplant"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-019-1560-2"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39406.652986.BE"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.09250914"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.5301\/jn.5000130"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-015-0024-6"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-019-1213-5"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-007-0256-6"},{"key":"e_1_2_7_14_1","unstructured":"StaggV.CHARLSON: Stata module to calculate Charlson index of comorbidity.2017."},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/0895-4356(94)90129-5"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"e_1_2_7_17_1","unstructured":"HowdenL MeyerJ.Age and Sex Composition:20102010 Census Briefs. United States Census Bureau: U.S. Department of Commerce2011."},{"key":"e_1_2_7_18_1","unstructured":"HouchensR ElixhauserA.Final Report on Calculating Nationwide Inpatient Sample (NIS) Variances for Data Years 2011 and Earlier. Vol. 2020. HCUP Methods Series Report # 2003\u201302 ONLINE. December 14 2015. U.S. Agency for Healthcare Research and Quality2015."},{"key":"e_1_2_7_19_1","doi-asserted-by":"crossref","unstructured":"IacusS KingG PorroG.CEM: Coarsened Exact Matching Software.2009.","DOI":"10.32614\/CRAN.package.cem"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1017\/pan.2019.11"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2011.03656.x"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.02980707"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.06170612"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2008121241"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2014050459"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40620-018-0509-z"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfaa247"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0138944"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ackd.2017.05.005"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1988.00380110013004"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/FTD.0b013e3182708edf"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.4103\/0971-4065.161018"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.4103\/0971-4065.202406"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/4539342"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2010.11.020"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1177\/2050312119843700"},{"key":"e_1_2_7_37_1","first-page":"CC01","article-title":"Normal pregnancy\u2010 a state of insulin resistance","volume":"8","author":"Sonagra AD","year":"2014","journal-title":"J Clin Diagn Res"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.02650707"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000001645"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2010.05.013"}],"container-title":["Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nep.13938","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/nep.13938","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nep.13938","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,3]],"date-time":"2024-09-03T19:49:31Z","timestamp":1725392971000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nep.13938"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,19]]},"references-count":39,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2021,11]]}},"alternative-id":["10.1111\/nep.13938"],"URL":"https:\/\/doi.org\/10.1111\/nep.13938","archive":["Portico"],"relation":{},"ISSN":["1320-5358","1440-1797"],"issn-type":[{"value":"1320-5358","type":"print"},{"value":"1440-1797","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,19]]},"assertion":[{"value":"2020-12-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-07-04","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-07-19","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}