A FITZPATRICK1, A GULYANI2, P CLAYTON1,2,3, SP MCDONALD, S JESUDASON1,3
1Central and Northern Adelaide Renal and Transplantation Services (CNARTS), Royal Adelaide Hospital, Adelaide, South Australia; 2ANZDATA and ANZOD Registry, South Australian Health & Medical Research Institute (SAHMRI), Adelaide, South Australia; 3School of Medicine, University of Adelaide, Adelaide, South Australia
Aim: To describe parenthood outcomes for fathers receiving renal replacement therapy (RRT).
Background: The effects of paternal uraemia, immunosuppression and comorbidity may affect offspring. Outcome data for pregnancies fathered by dialysed versus transplanted men is minimal.
Methods: Parenthood data reported to ANZDATA (1970-2014) was analysed using the Student’s t-test, chi-squared/Fisher’s exact test, and random effects linear and logistic regression.
Results: Overall, 872 men had 1248 conception events reported. Renal replacement therapy modality at conception was transplant for 925 (74%), haemodialysis for 275 (22%) and peritoneal dialysis for 48 (4%) of events. Transplanted fathers had mean±SD preconception serum creatinine of 155.9±56.6 umol/L. The parenthood data form introduced in 2001 improved data collection. After 2001, 529 parenthood events were reported. Gestational age (GA) was missing for only 2.5% and birthweight (BW) for 38.6% of reports.
The live birth rate (LBR) was 96.1% (1199 births) and similar between transplanted and dialysed men (97.9% vs. 96.2%, p=ns). The LBR for pregnancies reaching >20 weeks (where GA was known) was 99.7% for transplant fathers and 99.3% for dialysed fathers, comparable to national rates (99.3%, AIHW 2014). The mean±SD GA was 38.1±2.7 weeks, and BW 3.36±0.66kg. Treatment modality, time post-transplant and dialysis duration had no significant association with fetal outcome. Paternal mycophenolate use (n=358 events) was not associated with abnormal foetal morphology (OR 0.43, 95%CI 0.08, 2.37), and had no effect on LBR (OR 1.35, 95%CI 0.64, 2.84), GA (0.60 weeks, 95% CI 0.34, 1.54) or BW (85.6grams, 95%CI -59.6, 230.7).
Conclusions: A large number of fatherhood events have been reported to ANZDATA, facilitated by specific parenthood forms. No difference in fetal outcomes was observed between transplanted or dialysed fathers.