Pregnancy Outcomes in 53 Female Lung Transplant Recipients

This study analyzed pregnancy outcomes in female lung transplant (LuT) recipients, focusing on modifiable factors that could improve outcomes. Using data from the Transplant Pregnancy Registry International (TPRI), the study included 53 women who reported 72 pregnancies after LuT between 1991 and 2021. Most transplants were performed due to cystic fibrosis or pulmonary hypertension. Notably, only 36 percent of participants used contraception post-transplant, and 54 percent of the pregnancies were unplanned. The live birth rate was 62 percent; however, 60 percent of babies were premature and of low birth weight. Birth defects were reported in 16 percent of cases, but none were linked to mycophenolic acid usage.  Unplanned pregnancies were associated with lower maternal survival and poorer newborn outcomes, including lower gestational age and birth weight. In contrast, planned pregnancies resulted in healthier babies and better maternal survival. These findings highlight that effective pregnancy planning is the most important modifiable factor for improving outcomes for both mothers and their children after lung transplantation.