Early childhood hospital utilization and diagnoses for children born to mothers with kidney transplants: An Australian cohort study

Overview

Children of transplanted mothers are at increased risk of adverse birth outcomes, but childhood health outcomes are undefined. Using linked data from the Australia and New Zealand Dialysis and Transplant Registry, perinatal and hospital datasets, admissions were compared between children of transplanted mothers and mothers not exposed to kidney replacement therapy. From 2 067 661 babies, 137 children of transplanted mothers (137 birth admissions) were identified; 93 had 444 subsequent admissions, with a median follow-up of 2.3 years (interquartile range, 0.8-5.1). Subsequent admissions involved longer stays (>5 days: 7% versus 4%; P < .001) but similar admission frequencies (40% having 1 admission, 20% 2, 15% 3, 5% 4, and 20% ≥5; P = .31). Except for perinatal-originated conditions (3.7-fold higher admissions; 95% confidence interval, 2.1-6.5), other disease domains were similar between groups. Admission rates were comparable for preterm children, and children of mothers with hypertensive disorders of pregnancy, regardless of transplantation status. At birth, children of transplanted mothers required more ventilation (23% versus 5%, P < .001), medications (66% versus 31%, P < .001), and venous catheterization (19% versus 5%, P < .001). Medication use remained higher in subsequent admissions (19.7% versus 6.8%, P < .001). Hospital utilization data do not signal major additional health concerns beyond the perinatal period, providing reassuring evidence.